SIRPID (Stimulus Induced Rhythmic, Periodic, or Ictal Discharges)

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New nomenclature for SIRPID is: Stimulus-Induced (SI)Rhythmic Delta Activity (RDA) or Stimulus-Induced Generelized Periodic Discharges (GPD), dependent of the pattern of the discharges. [1]

Background

  • Stimulus Induced Rhythmic, Periodic, or Ictal Discharges (SIRPID)
  • Due to cortical and subcortical brain damage (thalamo-cortical dysfunction)
  • Often seen after acute brain injury (around 75%)
  • Discharges are induced by a tactile stimulus, i.e. touch or pain.

Clinic

  • In critically ill patients
  • 50% has (sub)clinical seizures.
  • Risk factor for development of status epilepticus.

EEG

  • Encephalopatic background EEG
  • Rhythmic delta discharges after a stimulus, i.e. pain.
  • Generalized or focal discharges.
  • Lasting seconds to hours


Generalized SIRPIDs after pain stimulus (blue line) (Average)

SIRPID-3.png



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