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Subclinical rhythmic EEG discharges in adults (SREDA) are rare and can be mistaken for epilepsy. This study characterized SREDA features to aid in accurate diagnosis and prevent misdiagnosis.

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Area of Science:

  • Neurophysiology
  • Electroencephalography (EEG)

Background:

  • Subclinical rhythmic EEG discharges in adults (SREDA) is a rare, benign EEG pattern.
  • Its electrophysiological features and variants are poorly understood.
  • SREDA can be misdiagnosed as ictal discharges, potentially leading to epilepsy misdiagnosis.

Purpose of the Study:

  • To report on patients with SREDA.
  • To identify the frequency of SREDA.
  • To characterize the clinical, demographic, and electrophysiological features of SREDA.

Main Methods:

  • Reviewed 22,234 EEG reports from 2012-2018.
  • Three neurophysiologists blindly reevaluated EEGs with SREDA.
  • Collected demographic, clinical, and neuroimaging data.

Main Results:

  • SREDA found in 14 EEG records (0.06%) among nine patients.
  • Mean patient age was 52.1 years; patients had various neurological conditions.
  • SREDA appeared contralateral to unilateral lesions; bilateral in others. Three patients were previously misdiagnosed.

Conclusions:

  • SREDA is difficult to associate with specific conditions or a single pathophysiology.
  • SREDA occurs in both young and older adults.
  • Differentiating SREDA from ictal discharges is crucial to prevent epilepsy misdiagnosis, especially in non-epileptic events.