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RTTBD-like activity in association with hippocampal ictal discharges in patients with temporal lobe epilepsy Volume 22, issue 4, August 2020

TEST YOURSELF

(1) What are the characteristics of rhythmic temporal theta bursts of drowsiness (RTTBD)?

 

(2) What symptoms are related to RTTBD?

 

(3) Is RTTBD only a benign EEG variant?

 

 

 

 

 

 

 

 

 

 

 

 

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Answers

(1) The pattern of RTTBD is sharply contoured, flat-topped or notched waves in the theta frequency band (4-7 Hz) over the mid-temporal region. It usually occurs in brief runs lasting a few seconds and rarely lasts longer than one minute. The pattern occurs unilaterally or bilaterally during drowsiness, sleep and wakefulness.

 

(2) RTTBD is strongly correlated with neurovegetative and psychiatric symptoms including headache, dizziness, panic episodes, anxiety, nausea, vomiting, blurred vision and syncope (Lipman and Hughes, 1969; Gibbs and Gibbs, 1989; Garvin, 1968). In addition, it is also associated with ictal automatisms during the period of psychomotor seizures (Gibbs et al., 1937). In our study, RTTBD was also related to cognitive impairment.

 

(3) RTTBD appears in 2% of normal young adults (Maulsby, 1979). Nevertheless, RTTBD is associated with ictal automatisms during the period of psychomotor seizures (Gibbs et al., 1937), and our study revealed intracranial ictal discharges correlating with scalp RTTBD and ictal discharges originating from the same hippocampal seizure onset in the amygdalohippocampal complex. After treatment with antiseizure medications, the majority (68%) of patients with neurovegetative and psychiatric symptoms with RTTBD patterns on EEG improved clinically, and the RTTBDpattern became less frequent or disappeared (Gibbs and Gibbs, 1989; Muller et al., 1988; Stone et al., 1986). RTTBD might rarely represent an intracranial ictal EEG pattern on standard EEG recordings in some people.

 

 

 

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