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Multifocal periodic lateralized epileptiform discharges (PLEDs): EEG features and clinical correlations

N D Lawn1, B F Westmoreland, F W Sharbrough

  • 1Department of Neurology, Mayo Clinic and Mayo Foundation, 200 First Street SW, MN 55905, Rochester, USA.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|November 25, 2000
PubMed

Insights

Multifocal periodic lateralized epileptiform discharges (PLEDs) indicate severe brain dysfunction. These EEG patterns are linked to serious underlying conditions and a high mortality rate of 57%.

Area of Science:

  • Neurology
  • Clinical Neurophysiology
  • Epileptology

Background:

  • Periodic lateralized epileptiform discharges (PLEDs) are EEG patterns associated with acute brain injury.
  • Multifocal PLEDs, involving three or more distinct EEG foci, represent a more complex cerebral disturbance.

Purpose of the Study:

  • To investigate the clinical characteristics and electroencephalographic (EEG) findings in patients presenting with multifocal PLEDs.
  • To determine the underlying etiologies and outcomes associated with multifocal PLEDs.

Main Methods:

  • Retrospective review of EEG recordings from 35 patients diagnosed with multifocal PLEDs (≥3 foci).
  • Analysis of patient demographics, clinical diagnoses, and mortality data.
  • Utilized Laplacian montages to enhance visualization of PLEDs' spatiotemporal distribution.

Main Results:

  • Common etiologies included vascular lesions (9), CNS infections (7), metabolic/toxic disorders (6), and seizure disorder exacerbation (6).
  • Other causes identified were hypoxic ischemic insults (3), fat embolism, paraneoplastic encephalitis, cerebral metastasis, and multiple sclerosis (1 each).
  • A significant mortality rate of 57% (20 out of 35 patients) was observed.

Conclusions:

  • Multifocal PLEDs are indicative of diffuse or multifocal cerebral dysfunction.
  • The presence of multifocal PLEDs signifies a severe disturbance in brain function.
  • Multifocal PLEDs are associated with a high mortality rate, underscoring their prognostic significance.
Abstract

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