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To the Editors, We read with great interest the article published by Huang et al 1 . The authors presented novel electroencephalography (EEG) findings: spiky beta bursts that preceded generalized synchronous delta rhythms as ictal activity during orofacial dyskinesia in patients with anti-N-methyl D-aspartate receptor (NMDAR) encephalitis. As the EEG findings were different from so-called extreme delta brush (EDB), which is a specific marker of anti-NMDAR encephalitis, 2 they referred to it as an extreme delta variant (EDV). Although the authors F I G U R E 1 EEG and EMG (monopolar montage). EEG shows generalized rhythmic or semirhythmic delta activity that is most prominent in the frontocentral region. Beta bursts overriding on the delta waves are visible only when the orofacial dyskinesia involved facial muscle contractions (yellow arrowheads) but absent when the dyskinesia was mild (blue arrowheads). The beta bursts were not synchronized with EMG activity from the deltoid (DEL) musclesThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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