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Neuroradiological Manifestations of Focal Polymorphic Delta Activity in Children

Neuroradiological Manifestations of Focal Polymorphic Delta Activity in Children Abstract • To examine the neuroradiological and clinical correlations of focal continuous polymorphic delta activity (PDA) in children, we reviewed the records of patients with continuous PDA that was either focal or lateralized to one hemisphere. Of 2571 electroencephalograms (EEGs) performed between July 1, 1988, and December 31, 1990, a total of 125 records from 87 patients revealed continuous PDA. Eighty of these patients had neuroimaging performed either by computed tomographic scan (n=59) or by magnetic resonance imaging (n=38) within 8 weeks of the EEG. Twenty-two patients (28%) showed no abnormalities on neuroimaging, 16 patients (20%) showed diffuse abnormalities, and 42 patients (52%) showed focal abnormalities that correlated with the EEG findings. Most (18 of 22) patients with no neuroradiological abnormalities presented to the hospital with seizures from various causes. The presence of focal spikes or additional focal EEG abnormalities did not differ significantly among the three imaging groups. Generalized EEG abnormalities and multifocal spikes were significantly more common among the patients who had generalized abnormalities on neuroimaging. Focal continuous PDA without correlated changes on neuroimaging occurred in 48% of patients, which is much higher than what has been reported in adults. References 1. Daly DD, Markand ON. Focal brain lesions . In: Daly DD, Pedley TA, eds. Current Practice of Clinical Electroencephalography . New York, NY: Raven Press; 1990:335-370. 2. Joynt RJ, Cape CA, Knott JR. Significance of focal delta activity in adult electroencephalography . Arch Neurol . 1965;12:631-638.Crossref 3. Weisberg LA, Nice C. Seizure disorders and electroencephalographic patterns . In: Weisberg L, Nice C, eds. Cerebral Computed Tomography . Philadelphia, Pa: WB Saunders Co; 1989:370-371. 4. Gilmore PC, Brenner RP. Correlation of EEG, computerized tomography, and clinical findings . Arch Neurol . 1981;38:371-372.Crossref 5. Marshall DW, Brey RL, Morse MW. Focal and/or lateralized polymorphic delta activity: association with either 'normal' or 'nonfocal' computer tomographic scans . Arch Neurol . 1988;45:33-35.Crossref 6. Schaul N, Green L, Peyster R, Gotoman J. Structural determinants of electroencephalographic findings in acute hemispheric lesions . Ann Neurol . 1986;20:703-711.Crossref 7. American Electroencephalographic Society. Guidelines in electroencephalography and evoked potentials . J Clin Neurophysiol . 1986;3( (suppl 1) ): 1-18. 8. Yang PJ, Berger PE, Cohen ME, et al. Computed tomography and childhood seizure disorders . Neurology . 1979;29:1084-1088.Crossref 9. Goldensohn ES. The use of the EEG for evaluation of focal intracranial lesions . In: Klass DW, Daly DD, eds. Current Practice of Clinical Electroencephalography . New York, NY: Raven Press; 1979:308-340. 10. Gotman J, Gloor P, Ray W. A quantitative comparison of traditional reading of the EEG and interpretation of computer extracted features in patients with supratentorial brain lesion . Electroencephalogr Clin Neurophysiol . 1975;38:623-639.Crossref 11. Gloor P, Ball G, Schaul N. Brain lesions that produce delta waves in the EEG . Neurology . 1977;27:326-333.Crossref 12. Gloor P, Kalaby O, Giard N. The electroencephalogram in diffuse encephalopathies: electroencephalographic correlates of grey and white matter lesions . Brain . 1968;91:779-802.Crossref 13. Sharbrough FW. Nonspecific abnormal EEG patterns . In: Niedermeyer E, Lopes daSilva F, eds. Electroencephalography: Basic Principals, Clinical Applications and Related Fields . Baltimore, Md: Urban & Schwarzenberg; 1987:1979-1980. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Neuroradiological Manifestations of Focal Polymorphic Delta Activity in Children

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1993.00540020057018
Publisher site
See Article on Publisher Site

Abstract

Abstract • To examine the neuroradiological and clinical correlations of focal continuous polymorphic delta activity (PDA) in children, we reviewed the records of patients with continuous PDA that was either focal or lateralized to one hemisphere. Of 2571 electroencephalograms (EEGs) performed between July 1, 1988, and December 31, 1990, a total of 125 records from 87 patients revealed continuous PDA. Eighty of these patients had neuroimaging performed either by computed tomographic scan (n=59) or by magnetic resonance imaging (n=38) within 8 weeks of the EEG. Twenty-two patients (28%) showed no abnormalities on neuroimaging, 16 patients (20%) showed diffuse abnormalities, and 42 patients (52%) showed focal abnormalities that correlated with the EEG findings. Most (18 of 22) patients with no neuroradiological abnormalities presented to the hospital with seizures from various causes. The presence of focal spikes or additional focal EEG abnormalities did not differ significantly among the three imaging groups. Generalized EEG abnormalities and multifocal spikes were significantly more common among the patients who had generalized abnormalities on neuroimaging. Focal continuous PDA without correlated changes on neuroimaging occurred in 48% of patients, which is much higher than what has been reported in adults. References 1. Daly DD, Markand ON. Focal brain lesions . In: Daly DD, Pedley TA, eds. Current Practice of Clinical Electroencephalography . New York, NY: Raven Press; 1990:335-370. 2. Joynt RJ, Cape CA, Knott JR. Significance of focal delta activity in adult electroencephalography . Arch Neurol . 1965;12:631-638.Crossref 3. Weisberg LA, Nice C. Seizure disorders and electroencephalographic patterns . In: Weisberg L, Nice C, eds. Cerebral Computed Tomography . Philadelphia, Pa: WB Saunders Co; 1989:370-371. 4. Gilmore PC, Brenner RP. Correlation of EEG, computerized tomography, and clinical findings . Arch Neurol . 1981;38:371-372.Crossref 5. Marshall DW, Brey RL, Morse MW. Focal and/or lateralized polymorphic delta activity: association with either 'normal' or 'nonfocal' computer tomographic scans . Arch Neurol . 1988;45:33-35.Crossref 6. Schaul N, Green L, Peyster R, Gotoman J. Structural determinants of electroencephalographic findings in acute hemispheric lesions . Ann Neurol . 1986;20:703-711.Crossref 7. American Electroencephalographic Society. Guidelines in electroencephalography and evoked potentials . J Clin Neurophysiol . 1986;3( (suppl 1) ): 1-18. 8. Yang PJ, Berger PE, Cohen ME, et al. Computed tomography and childhood seizure disorders . Neurology . 1979;29:1084-1088.Crossref 9. Goldensohn ES. The use of the EEG for evaluation of focal intracranial lesions . In: Klass DW, Daly DD, eds. Current Practice of Clinical Electroencephalography . New York, NY: Raven Press; 1979:308-340. 10. Gotman J, Gloor P, Ray W. A quantitative comparison of traditional reading of the EEG and interpretation of computer extracted features in patients with supratentorial brain lesion . Electroencephalogr Clin Neurophysiol . 1975;38:623-639.Crossref 11. Gloor P, Ball G, Schaul N. Brain lesions that produce delta waves in the EEG . Neurology . 1977;27:326-333.Crossref 12. Gloor P, Kalaby O, Giard N. The electroencephalogram in diffuse encephalopathies: electroencephalographic correlates of grey and white matter lesions . Brain . 1968;91:779-802.Crossref 13. Sharbrough FW. Nonspecific abnormal EEG patterns . In: Niedermeyer E, Lopes daSilva F, eds. Electroencephalography: Basic Principals, Clinical Applications and Related Fields . Baltimore, Md: Urban & Schwarzenberg; 1987:1979-1980.

Journal

Archives of NeurologyAmerican Medical Association

Published: Feb 1, 1993

References

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