ABSTRACT
PURPOSE: Periodic lateralized epileptiform discharges (PLEDs), initially described by Chatrian et al in 1964, are an EEG phenomenon characterized by lateralized or focal spike-and-wave complexes with moderate to high voltage which occur in a periodic or semiperiodic pattern. This study was performed to assess the clinical significance of PLEDs and its relation to an imaging study of the brain. MEHTODS: Twenty children (10 males and 10 females), from 2 days to 14 years of age, who had been hospitalized at Hanyang University Hospital were studied retrospectively. Their medical records, EEG results and brain imaging study were reviewed. RESULTS: Of the 20 patients studied, 15 patients showed unilateral PLEDs and 5 had bilateral PLEDs in EEG. Brain imaging studies were done for 18 of the patients, revealing abnormalities in 15 patients in this order of frequency: intracranial hemorrhage, diffuse cerebral atrophy, leukomalacia, cerebral infarctions, cerebral edema and hydrocephalus. PLED sites were not significantly correlated with the results of the imaging study. Finally, 3 patients died and 17 patients survived, and among the surviving 17 patients, 5 had recurrent seizures, 1 had recurrent seizures with mental regression, 3 had neurologic sequelae without seizures and 8 had no neurologic sequelae. CONCLUSION: We conclude that children who show PLEDs in EEG are more commonly associated with acute cerebral lesions and there is a high incidence of subsequent seizures and/or other neurological sequelae in surviving children with PLEDs.
Subject(s)
Child , Humans , Male , Atrophy , Brain Edema , Brain , Cerebral Infarction , Electroencephalography , Hydrocephalus , Incidence , Intracranial Hemorrhages , Medical Records , Neuroimaging , Retrospective Studies , SeizuresABSTRACT
PURPOSE: Periodic lateralized epileptiform discharges (PLEDs), initially described by Chatrian et al in 1964, are an EEG phenomenon characterized by lateralized or focal spike-and-wave complexes with moderate to high voltage which occur in a periodic or semiperiodic pattern. This study was performed to assess the clinical significance of PLEDs and its relation to an imaging study of the brain. MEHTODS: Twenty children (10 males and 10 females), from 2 days to 14 years of age, who had been hospitalized at Hanyang University Hospital were studied retrospectively. Their medical records, EEG results and brain imaging study were reviewed. RESULTS: Of the 20 patients studied, 15 patients showed unilateral PLEDs and 5 had bilateral PLEDs in EEG. Brain imaging studies were done for 18 of the patients, revealing abnormalities in 15 patients in this order of frequency: intracranial hemorrhage, diffuse cerebral atrophy, leukomalacia, cerebral infarctions, cerebral edema and hydrocephalus. PLED sites were not significantly correlated with the results of the imaging study. Finally, 3 patients died and 17 patients survived, and among the surviving 17 patients, 5 had recurrent seizures, 1 had recurrent seizures with mental regression, 3 had neurologic sequelae without seizures and 8 had no neurologic sequelae. CONCLUSION: We conclude that children who show PLEDs in EEG are more commonly associated with acute cerebral lesions and there is a high incidence of subsequent seizures and/or other neurological sequelae in surviving children with PLEDs.
Subject(s)
Child , Humans , Male , Atrophy , Brain Edema , Brain , Cerebral Infarction , Electroencephalography , Hydrocephalus , Incidence , Intracranial Hemorrhages , Medical Records , Neuroimaging , Retrospective Studies , SeizuresABSTRACT
Irrespective of focal lesion in brain imaging study, the deficits in cognitive function have been reported in mild traumatic brain injury patients. Therefore, they have been asked sensitive and objective assessment tools measuring cognitive deficits. In this study, traumatic brain injury patients were classified into lesion group and non-lesion group by presence of focal lesion in brain imaging study. At the same time, Results of Bender-Gestalt test, Standard Progressive Matrices, Cognitrone, and Signal Detection were analyzed among the groups. We assessed usefulness of Standard Progressive Matrices as assessment tool of intelligence in traumatic brain injury patients by correlation coefficients between KWIS and Standard Progressive Matrices intelligence quotients. 1) Most lesion group showed severe deficits in cognitive function, and most non-lesion group showed severe somatic symptoms. 2) The lesion group showed higher Bender-Gestalt test total error score than non-lesion group. 3) There was no difference in HWIS intelligence quotients between lesion and non-lesion group. 4) The lesion group showed lower performance than normal control and non-lesion group as increasing complexity of Standard Progressive Matrices subset. 5) The lesion group showed poor performance than normal control group in Cognitrone. 6) There were higher correlation coefficients than normal control group between Standard Progressive Matrices intelligence quotients and KWIS intelligence quotients in traumatic brain injury patients. According to the above results, lesion group showed deficits in space-construction ability, fine-motor coordination ability, form-memory ability, and delayed response-time. Although there are no statistical significance, comparing with normal control group, non-lesion group showed different response-trend in Cognitrone. Considering somatic symptoms in most non-lesion group and contribution of psychological factors in maintenance of symptoms in mild traumatic brain injury patients, the differences in Cognitrone must be interpreted carefully. These result suggest than Standard Progressive Matrices can be a useful tool for assessment of intelligence in traumatic brain injury patients who showed deficits in cognitive function.