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Periodic lateralized epileptiform discharges (PLEDs) as early indicator of stroke in full-term newborns

T Randò1, D Ricci, E Mercuri

  • 1Child Neurology and Psychiatry Unit, Catholic University, Rome, Italy.

Neuropediatrics
|November 9, 2000
PubMed

Insights

Periodic lateralized epileptiform discharges (PLEDs) on EEG indicate neonatal convulsions. These EEG abnormalities, seen in infants with normal ultrasounds, correlated with cerebral infarction found via MRI.

Area of Science:

  • Neonatal neurology
  • Neurophysiology
  • Pediatric epilepsy

Background:

  • Neonatal convulsions are a critical concern in infant neurology.
  • Electroencephalography (EEG) is crucial for diagnosing seizure disorders in neonates.
  • Cerebral infarction can manifest in newborns, posing significant neurological risks.

Observation:

  • Two infants presented with neonatal convulsions and subsequent EEG abnormalities.
  • Periodic lateralized epileptiform discharges (PLEDs) were observed on EEG shortly after seizure onset.
  • Initial cranial ultrasounds appeared normal in both neonates.

Findings:

  • Magnetic Resonance Imaging (MRI) revealed cerebral infarction in both infants.
  • In one case, the MRI lesion location corresponded with EEG abnormalities.
  • The second infant's MRI showed a basal ganglia lesion, also linked to PLEDs.

Implications:

  • EEG findings, particularly PLEDs, can precede detectable structural abnormalities on ultrasound in neonatal convulsions.
  • MRI is essential for identifying cerebral infarction underlying neonatal seizures.
  • Understanding the correlation between EEG patterns and specific lesion locations aids in diagnosing and managing neonatal neurological conditions.

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