A Study on the Clinical Significance of Periodic Lateralized Epileptiform Discharges and Relation to Brain Imaging Study in Children

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.