Unilateral SREDA in a Patient with Stroke

Subclinical rhythmic electrographic discharges in adults (SREDA) is a well-known benign EEG phenomenon. However, the occurrence of SREDA is rare, and atypical forms are even more elusive, with only few cases reported in the literature. Herein, we describe a case of a 77-year-old woman with a left middle cerebral artery stroke and paroxysms of rhythmic, sharply contoured activity over the right central head region, mimicking focal seizures on EEG, that were determined to represent atypical SREDA. To our knowledge, no case of SREDA with a contralateral structural cerebral abnormality has been described, and its occurrence offers some limited insight as to the mechanisms underlying this mysterious entity.