Temporal THETA Bursts!

Posted on

December 22, 2023

Let's learn all the facts about a brain pattern called

References:

Yamada, Thoru, and Elizabeth Meng. Practical Guide for Clinical Neurophysiologic Testing: EEG. Available from: Wolters Kluwer, (2nd Edition). Wolters Kluwer Health, 2017. Greenfield, John, L. et al. Reading EEGs: A Practical Approach. Available from: Wolters Kluwer, (2nd Edition). Wolters Kluwer Health, 2020.

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Newborn | Neupsy Key

This pattern has also been termed “temporal sharp transient";, "temporal sawtooth”, “sawtooth temporal theta”. The pattern consists of brief bursts of rhythmic, sharply contoured 4Hz to 7Hz theta bursts with an amplitude of 100μV to 200μV. The bursts are generally 1-2 seconds in duration and can appear independently in the left and right midtemporal regions. The pattern occurs in very premature infants between 29 weeks and 32 weeks conceptual age. It then rapidly diminishes and should subside by 34 weeks conceptual age.

Question:

Sharply contoured features of the dysmature brain are commonly seen in neonatal recordings. Some are considered normal, but when are sharp transients in neonates considered abnormal?

Frequent discharges

Persistent focal discharges

Rhythmic discharges

Any of the above may constitute epileptiform activity depending on conceptual age

Correct Answer:

Discharges that are extremely frequent, persistent in one area, or become rhythmic are concerning for epileptiform activity rather than just sharp transients.

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