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Temporal Intermittent Rhythmic Delta Activity (TIRDA) in the Diagnosis of Complex Partial Epilepsy: Sensitivity, Specificity and Predictive Value

Published online by Cambridge University Press:  18 September 2015

Jean Reiher ,
Michel Beaudry  and
Charles P. Leduc
Jean Reiher*
Affiliation:
Department of Neurology, University of Sherbrooke, School of Medicine, Sherbrooke, Quebec
Michel Beaudry
Affiliation:
Department of Neurology, University of Sherbrooke, School of Medicine, Sherbrooke, Quebec
Charles P. Leduc
Affiliation:
Department of Community Health Sciences, University of Sherbrooke, School of Medicine, Sherbrooke, Quebec
*
Department of Neurology, University of Sherbrooke, 3001, 12th Avenue North, Sherbrooke, Quebec, Canada J1H
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Abstract:

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Temporal interictal rhythmic delta activity or TIRDA was found in 45 of the 127 recordings of patients with complex partial epilepsy (CPE) referred for both awake and sleep EEC TIRDA was more abundant during drowsiness and light sleep; it occurred more characteristically as trains of 50-100 µv sinusoidal or saw-toothed l-4Hz activity, recorded predominantly from anterior temporal regions. When occurring bilaterally and independently, TIRDA varied from side to side. TIRDA is often found in association with anterior temporal spikes or sharp waves (TS) particularly during sleep, as observed in 43 out of 45 EEGs. TIRDA can nevertheless occur as an isolated abnormality, as noted in two sleep and 12 awake study recordings. Because of its high specificity and positive predictive value over a large range of prevalence, TIRDA should be singled out as an accurate interictal indicator of CPE. In patients with isolated TIRDA, the cost of prolonged EEG recording during sleep for the purpose of activating TS has to be weighed against the yield of eventually confirming the obvious.

Résumé:

RÉSUMÉ:

Chez 35 % des malades adressés pour investigation d'une épilepsie partielle complexe, l’électroencéphalogramme a révélé en temporal une activité delta rythmique inter-critique (TIRDA). Plus abondant durant somnolence et sommeil léger, le TIRDA se présente plus classiquement sous forme de train d'ondes de 1 à 4Hz, d'une amplitude allant de 50 à 100 µv. Lorsque bilatéral, le TIRDA survient de façon asynchrone et avec une morphologie distincte de chaque côté. Souvent associé à des pointes temporales antérieures (TS), le TIRDA peut se retrouver néanmoins de façon isolée. A cause de sa très grande spécificité et de sa valeur prédictive élevée pour un large spectre de prévalence, le TIRDA mérite d'être retenu comme un indicateur intercritique pathognomonique de l’épilepsie partielle complexe. Les inconvénients d'un enregistrement prolongé pendant le sommeil, à la recherche de la pointe temporale classique, méritent d'être souspesés lorsque le TIRDA représente la seule anomalie recueillie lors d'un électroencéphalogramme initial.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 16 , Issue 4 , November 1989 , pp. 398 - 401
Copyright
Copyright © Canadian Neurological Sciences Federation 1989

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