Stimulus-Induced Rhythmic or Periodic Intermittent Discharges (SIRPIDs) in patients with triphasic waves and Creutzfeldt-Jakob disease

Since the term Stimulus-Induced Rhythmic, Periodic, or Ictal Discharges (SIRPIDs) was introduced into vocabulary of electrophysiologists/neurologists, there has been an ongoing debate about its significance, as well correlation with outcomes. SIRPIDs are frequently seen in patients who critically ill from various causes. The literature reflects findings triphasic morphology, generalized periodic discharge (GPD) classification many SIRPIDs: toxic/metabolic encephalopathies, septic, and hypoxemic/hypercapnic but also sharp complexes Creutzfeldt-Jakob disease advanced Alzheimer’s disease. In these settings, GPDs disappear when fall asleep reappear spontaneously wake up, awoken by external stimulus, sometimes because a respiratory event, possibility appearance cyclic alternating pattern. may be transitional pattern between sleep waking states, corresponding to postarousal/awakening phenomenon. As transient phenomenon can usually recorded repeatedly each stimulation, word “Ictal” could replaced “Intermittent”: Rhythmic Periodic Intermittent Discharges. However, considering that “potentially ictal” on “ictal–interictal continuum“ some situations, “plus” modifier added: SIRPIDs-plus.