Levodopa-induced Thrombocytopenia

Drug-induced thrombocytopenia can be caused by various medications and should be suspected in any patients with newly developed thrombocytopenia. We report a patient with severe thrombocytopenia induced by L-dopa. This is the first case report on L-dopa-induced thrombocytopenia in Korea.

A Case of Cerebrospinal Fluid Hypovolemic Syndrome with Impairment of the Level of Consciousness

We report a 39-year-old man who had newly developed a postural headache followed by a progressive decline in his level of consciousness with behavioral changes. Magnetic resonance imaging of the brain and radioisotope cisternography revealed typical findings of cerebrospinal fluid (CSF) hypovolemic syndrome combined with bilateral subdural hematoma and diencephalic compression. His headache and mental status improved after repeated epidural blood patches. Early detection of this rare complication and rapid treatment such as blood patches are very important in the treatment of these patients.

Classification and Serial Evolution of PLEDs

BACKGROUND AND PURPOSE: Periodic lateralized epileptiform discharges (PLEDs) are defined as spikes or sharp waves occurring at an approximately regular interval. PLEDs are subdivided into PLEDs proper and PLEDs plus in Reiher's classification, but since this does not sufficiently reflect the pleomorphism of PLEDs, we propose a new subclassification scheme of PLEDs, and discuss the relationship between them and clinical prognoses. METHODS: Thirty-seven patients who had at least two available EEGs were included in this study. Each patient had structural brain lesions identified in brain CT/MRI: 237 EEGs from 37 patients were reviewed and the patterns of PLEDs were classified by electroencephalographic characteristics based on Reiher's classification. PLEDs proper of class 3 were subclassified into four categories: (1) simple, (2) benign, (3) vigorous, and (4) suppressed. RESULTS: Most of the PLEDs that started with the vigorous or suppressed pattern of class 3 evolved into the simple or benign pattern of class 3 and subsequently changed into class 1 or class 2, finally intermingling with the neighboring background waves. PLEDs that started with the benign or simple pattern of class 3 rapidly changed into class 1 or 2. Patients showing the benign or simple pattern of class 3 exhibited a better clinical prognosis. CONCLUSIONS: PLEDs have five distinctive classes, and over time they evolve from malignant PLEDs plus to benign PLEDs proper before finally disappearing. It appears that those of class 3 have more diverse patterns, with the vigorous and suppressed patterns being the more malignant forms of PLEDs in this class.