{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T10:32:42Z","timestamp":1779100362849,"version":"3.51.4"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000},"content-version":"vor","delay-in-days":57,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The ictal\u2010interictal continuum represents a diagnostic challenge even for expert neurrophysiologists, often requiring an additional multimodal diagnostic workup to understand its clinical significance. Lateralised rhythmic delta activity (LRDA) is an ictal\u2010interictal continuum pattern that has only recently been investigated and recognised as potentially ictogenic or sometimes even ictal.<\/jats:p><jats:p>We describe a patient who presented with acute\u2010onset aphasia, initially suspected of having a stroke; advanced brain imaging with CT\u2010perfusion showed features suggesting regional left temporo\u2010parietal hyperperfusion and an EEG revealed LRDA with fluctuations and intermixed sharp waves in the same areas. Treatment with lacosamide caused both clinical and EEG improvement after a few hours, supporting the hypothesis that the EEG pattern represented an ictal\/interictal phenomenon.<\/jats:p><jats:p>In the literature, a correlation between metabolic\/perfusion imaging and ictal\u2010interictal continuum patterns is described regarding lateralised periodic discharges but less studied for LRDA.<\/jats:p><jats:p>In this case, we adopted a multimodal approach, integrating advanced imaging, EEG, clinical features, and response to therapy, to consider the overall clinical presentation as focal NCSE.<\/jats:p>","DOI":"10.1684\/epd.2020.1169","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T13:01:14Z","timestamp":1593435674000},"page":"337-341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A multimodal diagnostic approach for lateralised rhythmic delta activity in the 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