TY  - BOOK
AU  - Spalletti,Maddalena
AU  -  Pescini,Francesca
AU  -  Gadda,Davide
AU  -  Piccardi,Benedetta
AU  -  Scarpino,Maenia
AU  -  Carrai,Riccardo
AU  -  Boccardi,Cristina
AU  -  Grippo,Antonello
AU  -  Amantini,Aldo
TI  - A multimodal diagnostic approach for lateralised rhythmic delta activity in the ictal-interictal continuum
PY  - 2020///.
							
N1  - 22
N2  - The ictal-interictal continuum represents a diagnostic challenge even for expert neurrophysiologists, often requiring an additional multimodal diagnostic workup to understand its clinical significance. Lateralised rhythmic delta activity (LRDA) is an ictal-interictal continuum pattern that has only recently been investigated and recognised as potentially ictogenic or sometimes even ictal.We describe a patient who presented with acute-onset aphasia, initially suspected of having a stroke; advanced brain imaging with CT-perfusion showed features suggesting regional left temporo-parietal hyperperfusion and an EEG revealed LRDA with fluctuations and intermixed sharp waves in the same areas. Treatment with lacosamide caused both clinical and EEG improvement after a few hours, supporting the hypothesis that the EEG pattern represented an ictal/interictal phenomenon.In the literature, a correlation between metabolic/perfusion imaging and ictal-interictal continuum patterns is described regarding lateralised periodic discharges but less studied for LRDA.In this case, we adopted a multimodal approach, integrating advanced imaging, EEG, clinical features, and response to therapy, to consider the overall clinical presentation as focal NCSE
UR  - https://shs.cairn.info/revue-epileptic-disorders-2020-3-page-337?lang=en&redirect-ssocas=7080
ER  -