Incidence and prognosis of frontal intermittent rhythmic delta activity in King Fahad Hospital-Hofuf intensive care unit

Abstract

Objective: This study aimed to verify the rate of occurrence of frontal intermittent rhythmic delta activity (FIRDA) in electroencephalograms (EEGs) of adult patients in the intensive care unit (ICU) and its correlation with either neurological or non-neurological etiologies or prognoses. Methods: A retrospective review was performed on 239 EEGs with analysis of their neuroimages and clinical data from an ICU at King Fahad Hospital, Hufof from November 2021 to October 2022. A literature review was also conducted using the PUBMED database. The search scope was covered by the keyword "FIRDA" and was limited to English-language articles. Results: A total of 239 EEGs were conducted in the ICU, 19 (7.9%) had either electrographic or clinical seizures with or without slowing and/or interictal epileptiform discharges, 6 (2.5%) EEGs had FIRDA, and the rest of the EEGs (80.5%) had only generalized slow or rarely other EEG patterns which were noted in coma. Toxic metabolic disturbances and sepsis were the acute diagnoses of all the observed cases. There were no clinical seizures in the patients who had FIRDA and no history of epilepsy. There was no significant association between FIRDA and the seizure occurrence where the p-value was 1 (Confidence interval—0, 10.28). Conclusion: This study provides valuable insights into the incidence, clinical characteristics, and outcomes of FIRDA in critically ill patients admitted to the ICU. While FIRDA remains a relatively uncommon finding, its association with toxic-metabolic disturbances and sepsis underscores the importance of comprehensive neurological monitoring in critically ill patients.