Detailed electroencephalographic long-term follow-up study in Lewy body dementia with periodic sharp wave complexes

Fernández‐Torre, José L.; Figols, J.; Alonso, I.; Leno, Carlos; Martínez-Martínez, Marián; Carpizo, Rosario; Altable, Marcos

doi:10.1007/s00415-006-0367-9

Cited by 7 publications

(8 citation statements)

References 17 publications

(20 reference statements)

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“…More broadly, LBD patients typically exhibit increased posterior slow-wave activity relative to healthy controls and individuals with AD ( Bonanni et al, 2008 , Briel et al, 1999 , Calzetti et al, 2002 , Fernandez-Torre et al, 2007 , Roks et al, 2008 ). Clinically, this increased slow-wave activity has been found to positively correlate with the presence and severity of cognitive fluctuations ( Bonanni et al, 2008 , Walker et al, 2000b ).…”

Section: Discussionmentioning

confidence: 99%

Neurophysiological biomarkers for Lewy body dementias

Cromarty

Elder

Graziadio

et al. 2016

Clinical Neurophysiology

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Section: Discussionmentioning

confidence: 99%

Neurophysiological biomarkers for Lewy body dementias

Cromarty

Elder

Graziadio

et al. 2016

Clinical Neurophysiology

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“…However, the strict criteria for the definition of PSD in CJD may possibly suggest the duration of 100–600 ms, the intercomplex interval of 500–2000 ms, which may possibly assist the differentiation [11]. According to Ferna’ndez-Torre [12], the EEG in DLB has different abnormalities in different phases. During the initial phase of DLB, EEG showed a mild slowing of background activity with diffuse 5–7 Hz rhythms, and occasional bilateral bursts of arrhythmic irregular 1.5–2.0 Hz slow waves.…”

Section: Discussionmentioning

confidence: 99%

Dementia with Lewy bodies versus nonconvulsive status epilepticus in the diagnosis of a patient with cognitive dysfunction, complex visual hallucinations and periodic abnormal waves in EEG: a case report

et al. 2014

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BackgroundThe diagnosis of dementia with Lewy bodies (DLB) is often challenging in elderly individuals, not only for its various clinical features, sometimes, but also for its rare changes of periodic synchronous discharges (PSD) in electroencephalogram ( EEG). So, we reported one case of DLB and gave a detailed analysis.Case presentationA Chinese patient (Female, 56 years old) presented with progressive cognitive decline and complex visual hallucinations. Several days after admission, she gradually showed focal myoclonic jerks. Mini-Mental State Examination (MMSE) score was 19/30, EEG revealed PSD, Cerebrospinal fluid and 14-3-3 brain protein was negative, Magnetic resonance imaging (MRI) showed diffuse atrophy. To differentiate the PSD derived from DLB or from late-onset Absence Status Epilepticus, we have given the treatment with intravenous valproate (1200 mg/24 h) and diazepam 20 mg under the EEG monitor, a clinical improvement was absent and PSD in EEG did not disappear. Two weeks later, the patient showed akinetic-rigid syndrome and PSD in EEG persisted for a long time. According to her history and therapy, a clinical diagnosis of DLB has been made, but no autopsy for confirmation, and in the following visit, she has a poor prognosis.ConclusionPSD in EEG may occasionally be recorded in neurodegenerative disorders such as AD, DLB other than CJD or NCSE. Hence it should not dissuade clinicians from the diagnosis of DLB where the clinical and neuropsychological findings were consistent with suggested diagnostic criteria for DLB.

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“…Interestingly, atypical TWs occurred years before the appearance of GPDs in a subject with Lewy body dementia. 93 Young et al 65 found typical and atypical TWs in their study of sepsis-associated encephalopathy, but the authors did not specify the criteria used for atypical TWs. Six of 62 patients had TWs.…”

Section: Discussionmentioning

confidence: 99%

Atypical or Typical Triphasic Waves—Is There a Difference? A Review

Fernández‐Torre

Kaplan

2021

Journal of Clinical Neurophysiology

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The entity of triphasic waves (TWs) and TW encephalopathy has derived from the subjective art of EEG interpretation. Indeed, there are few if any guidelines regarding many different aspects of TWs. The authors seek to shed light on the nature and the diagnostic characteristics of various types of TWs, differentiating "typical" from "atypical" forms. The authors conclude that morphologies in the form of bursts of well-formed, smoothly contoured, negative-positive-negative, bilateral, symmetrical and synchronous, regular, reactive, periodic or rhythmic, 1.5 to 2.0 Hz, fronto-central, triphasic complexes with frontooccipital lag meet the criteria for typical TWs and are highly suggestive of toxic-metabolic encephalopathies. These are most frequently hepatic, uremic, or sepsis-associated encephalopathies with multi-organ failure. In such cases, atypical TWs (frontopolar or parieto-occipital maximum, negative-positive or negativepositive-negative, asymmetric and asynchronous, unreactive, irregular, multifocal, continuous with spatiotemporal evolution, sharper and without fronto-occipital/occipito-frontal lag, or triphasic delta waves) are rarely seen. Atypical TWs are encountered in Angelman syndrome, toxic encephalopathies, hyperthyroidism/hypothyroidism, Hashimoto encephalopathy, nonconvulsive status epilepticus, dementia, sepsis-associated encephalopathy, cerebrovascular disorders, and certain boundary syndromes. Investigations describing TWs with uncommon etiologies revealed few with typical TWs, suggesting that the term "TWs" has been overused in the past. Triphasic waves arise from the interaction of multiple factors including toxic, metabolic, infectious, and structural disorders that affect circuits between thalamus and cortex. The patient's metabolic status, presence of potentially neurotoxic drugs, cerebral atrophy, white matter disease, dementia, or seizures help differentiate typical from typical TWs. Future studies will determine whether this dichotomy is heuristically and clinically helpful.

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Detailed electroencephalographic long-term follow-up study in Lewy body dementia with periodic sharp wave complexes

Cited by 7 publications

References 17 publications

Neurophysiological biomarkers for Lewy body dementias

Neurophysiological biomarkers for Lewy body dementias

Dementia with Lewy bodies versus nonconvulsive status epilepticus in the diagnosis of a patient with cognitive dysfunction, complex visual hallucinations and periodic abnormal waves in EEG: a case report

Atypical or Typical Triphasic Waves—Is There a Difference? A Review

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