TY - JOUR
T1 - Atypical presentation of subclinical rhythmic electrographic discharge of adults (sreda) in a patient with idiopathic generalized epilepsy
AU - Poothrikovil, Rajesh P.
AU - Asmi, Abdullah Al
AU - Gujjar, Arunodaya
PY - 2012/3/1
Y1 - 2012/3/1
N2 - Subclinical rhythmic electrographic discharge of adults (SREDA) is considered a benign EEG pattern of uncertain significance, although it may closely resemble an electrographic seizure pattern. SREDA was first described by Westmoreland and Klass in 1981 as a distinctive rhythmic and rare EEG pattern primarily seen in older subjects. The typical pattern consists of sharp contoured, non-evolving 5 to 7 Hz theta rhythm with a widespread bilaterally synchronous distribution, but maximal over the parietal and posterior temporal regions. It usually lasts for a few seconds to several minutes without clinical association. Later in 1997, several unusual variants of SREDA were reported consisting of variations in frequency, morphology, topographic distribution, duration, and stage of alertness. We report SREDA in a patient with idiopathic generalized epilepsy which shows some atypical features (such as asynchronous onset, bifid waveforms, asymmetry, and fragmentation) and mimics a secondarily generalized partial seizure. It is important to successfully identify SREDA to avoid misdiagnosis and incorrect treatment. The technologist's contribution is essential and valuable. EEG technologists and interpreters should be aware of typical and atypical features of SREDA and its wide spectrum.
AB - Subclinical rhythmic electrographic discharge of adults (SREDA) is considered a benign EEG pattern of uncertain significance, although it may closely resemble an electrographic seizure pattern. SREDA was first described by Westmoreland and Klass in 1981 as a distinctive rhythmic and rare EEG pattern primarily seen in older subjects. The typical pattern consists of sharp contoured, non-evolving 5 to 7 Hz theta rhythm with a widespread bilaterally synchronous distribution, but maximal over the parietal and posterior temporal regions. It usually lasts for a few seconds to several minutes without clinical association. Later in 1997, several unusual variants of SREDA were reported consisting of variations in frequency, morphology, topographic distribution, duration, and stage of alertness. We report SREDA in a patient with idiopathic generalized epilepsy which shows some atypical features (such as asynchronous onset, bifid waveforms, asymmetry, and fragmentation) and mimics a secondarily generalized partial seizure. It is important to successfully identify SREDA to avoid misdiagnosis and incorrect treatment. The technologist's contribution is essential and valuable. EEG technologists and interpreters should be aware of typical and atypical features of SREDA and its wide spectrum.
KW - Atypical features
KW - Benign variants
KW - Eeg
KW - Electrographic seizure
KW - Hyperventilation
KW - Subclinical rhythmic electrographic discharge of adults (sreda)
UR - http://www.scopus.com/inward/record.url?scp=84861517014&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861517014&partnerID=8YFLogxK
U2 - 10.1080/21646821.2012.11079842
DO - 10.1080/21646821.2012.11079842
M3 - Article
C2 - 22558646
AN - SCOPUS:84861517014
SN - 2164-6821
VL - 52
SP - 42
EP - 53
JO - Neurodiagnostic Journal
JF - Neurodiagnostic Journal
IS - 1
ER -