Subclinical rhythmic EEG discharge of adults: “SREDA in a child”

Dash, Gopal Krishna; Sundaran, Soumya; Radhakrishnan, Ashalatha

doi:10.1016/j.seizure.2012.12.006

Cited by 6 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subclinical rhythmic electrographic discharges of adults is a rare benign EEG variant that was first described by Naquet et al in 1961 200 and later defined by Westmoreland and Klass. 201 The reported prevalence of SREDA is 0.04-0.12% in adults 118,[202][203][204] and a more recent studied showed an incidence of 0.03%. 121 SREDA is possibly the least common of benign EEG variant.…”

Section: Sreda ("Subclinical Rhythmic Electrographic Discharges Of Ad...mentioning

confidence: 98%

“…It is one of the most challenging patterns, as it can be easily overinterpreted as epileptic due to its resemblance to ictal patterns. It is seen in adults (mostly older adults) 201,205 although it has been rarely reported in children and adolescents 118,204,206‐208 . On visual inspection, it consists of repetitive sharply contoured, monomorphic (rhythmic), sinusoidal waves.…”

Section: Normal Variants or Variants Of Uncertain Clinical Significancementioning

confidence: 99%

“…Typical SREDA is nonevolving rhythmic theta activity. Atypical SREDA evolves in frequency from delta to theta with either a gradual or an abrupt offset 204 . One study using frequency spectral analysis and Laplacian montages suggested that SREDA is composed of “a complex mixture of multiple rapidly shifting frequencies predominantly in the theta range, which show poor spatial and temporal resolution” 209 .…”

Section: Normal Variants or Variants Of Uncertain Clinical Significancementioning

confidence: 99%

See 2 more Smart Citations

Normal variants and artifacts: Importance in EEG interpretation

Amin

Nascimento

Karakis

et al. 2023

Epileptic Disorders

View full text Add to dashboard Cite

Overinterpretation of EEG is an important contributor to the misdiagnosis of epilepsy. For the EEG to have a high diagnostic value and high specificity, it is critical to recognize waveforms that can be mistaken for abnormal patterns. This article describes artifacts, normal rhythms, and normal patterns that are prone to being misinterpreted as abnormal. Artifacts are potentials generated outside the brain. They are divided into physiologic and extraphysiologic. Physiologic artifacts arise from the body and include EMG, eyes, various movements, EKG, pulse, and sweat. Some physiologic artifacts can be useful for interpretation such as EMG and eye movements. Extraphysiologic artifacts arise from outside the body, and in turn can be divided into the environments (electrodes, equipment, and cellphones) and devices within the body (pacemakers and neurostimulators). Normal rhythms can be divided into awake patterns (alpha rhythm and its variants, mu rhythm, lambda waves, posterior slow waves of youth, HV‐induced slowing, photic driving, and photomyogenic response) and sleep patterns (POSTS, vertex waves, spindles, K complexes, sleep‐related hypersynchrony, and frontal arousal rhythm). Breach can affect both awake and sleep rhythms. Normal variants or variants of uncertain clinical significance include variants that may have been considered abnormal in the early days of EEG but are now considered normal. These include wicket spikes and wicket rhythms (the most common normal pattern overread as epileptiform), small sharp spikes (aka benign epileptiform transients of sleep), rhythmic midtemporal theta of drowsiness (aka psychomotor variant), Cigánek rhythm (aka midline theta), 6 Hz phantom spike–wave, 14 and 6 Hz positive spikes, subclinical rhythmic epileptiform discharges of adults (SREDA), slow‐fused transients, occipital spikes of blindness, and temporal slowing of the elderly. Correctly identifying artifacts and normal patterns can help avoid overinterpretation and misdiagnosis. This is an educational review paper addressing a learning objective of the International League Against Epilepsy (ILAE) curriculum.

show abstract

Section: Sreda ("Subclinical Rhythmic Electrographic Discharges Of Ad...mentioning

confidence: 98%

Section: Normal Variants or Variants Of Uncertain Clinical Significancementioning

confidence: 99%

Section: Normal Variants or Variants Of Uncertain Clinical Significancementioning

confidence: 99%

See 1 more Smart Citation

Normal variants and artifacts: Importance in EEG interpretation

Amin

Nascimento

Karakis

et al. 2023

Epileptic Disorders

View full text Add to dashboard Cite

show abstract

“…These features were separately reported in different patients older than 35 years of age and in three children aged 5, 10, and 11 years. [ 6 7 ] Further, within the identified clinical diagnoses, only two of the atypical SREDA patients had seizures and other epileptiform abnormalities that were distinct from SREDA. [ 2 ]…”

Section: Introductionmentioning

confidence: 99%

A unique presentation of atypical SREDA pattern in a young healthy woman

Murr

Bertoni

2015

Ann Indian Acad Neurol

View full text Add to dashboard Cite

show abstract

“…10 The other 3 did not have any history of seizure or a diagnosis of epilepsy. 1,10,11 We present a case of a 17-year-old teenage male with SREDA in sleep and wakefulness who was diagnosed and treated as epilepsy.…”

mentioning

confidence: 99%

Atypical SREDA During Wakefulness, NREM and REM Sleep in a Young Teenager: A Diagnostic Challenge

2019

View full text Add to dashboard Cite

Subclinical rhythmic electrographic discharges of adult (SREDA) is a rare variant considered to be normal in EEG. It consists of sharp-contoured or sinusoidal waveforms in the theta frequency range (usually 5-7 Hz), occurring in a widespread distribution, often maximal over the parietotemporal regions. SREDA is usually bilateral but could be unilateral (atypical SREDA). Compared with true ictal activities, SREDA has little change in frequency, morphology, and distribution. It has been described in adults and is extremely rare in children/adolescents. There are only 5 cases published in children. We report a case of atypical SREDA in a child that may have occurred in wakefulness, non–rapid eye movement (NREM) sleep, and REM sleep. This finding was initially misdiagnosed as epilepsy. Inpatient video-EEG demonstrated that during periods of SREDA in quiet wakefulness the patient did not have any signs or symptoms with the SREDA pattern; SREDA abated whenever the patient was alerted or if he spontaneously initiated some activities. SREDA with same morphology was noted in NREM and REM sleep. The patient had no true epileptogenic abnormalities and hence antiepileptic medication was discontinued and stopped uneventfully. This case illustrates the importance of recognizing this rare variant, avoiding a misdiagnosis of epilepsy as it occurred in our case.

show abstract

Subclinical rhythmic EEG discharge of adults: “SREDA in a child”

Cited by 6 publications

References 13 publications

Normal variants and artifacts: Importance in EEG interpretation

Normal variants and artifacts: Importance in EEG interpretation

A unique presentation of atypical SREDA pattern in a young healthy woman

Atypical SREDA During Wakefulness, NREM and REM Sleep in a Young Teenager: A Diagnostic Challenge

Contact Info

Product

Resources

About