What EEG findings are characteristic of Binswanger disease?

Updated: Oct 09, 2019
  • Author: Eli S Neiman, DO, FACN; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Binswanger disease usually demonstrates slowing of background and a nonspecific pattern. Kuroda et al reported other patterns, describing a 72-year-old patient with von Recklinghausen disease who exhibited akinetic mutism within 6 months of the onset of dementia. Encephalography (EEG) demonstrated periodic synchronous discharges (PSDs), suggesting Creutzfeldt-Jakob disease (CJD). Computed tomography (CT) of the brain identified diffuse cerebral atrophy. Autopsy findings revealed diffuse subcortical white matter disease and marked arteriosclerotic changes of the subcortical arterioles. [32]

The cortex was relatively spared, and the pathologic diagnosis confirmed Binswanger disease. Binswanger disease, therefore, can present with PSDs and should be included in the differential diagnosis of dementia. On the other hand, Dzialek et al described a group of 15 patients with Binswanger subcortical atherosclerotic encephalopathy who showed a different EEG appearance. The EEG records were pathological in most cases, with varying degrees of slow activity that was distributed symmetrically. [33]


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