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BIPLEDs in akinetic mutism caused by bilateral anterior cerebral artery infarction
J Nicolai1, M J van Putten, D L Tavy
1Department of Neurology and Clinical Neurophysiology, Ziekenhuis Leyenburg, Leyweg 275, 2545 CH Den Haag, The Netherlands. jnicolaidenhaag@hotmail.com
Introduction:
Akinetic mutism is described as a result of many disorders. Bilateral infarction of the anterior cerebral artery (ACA) territory is reported rarely, however, often leading to akinetic mutism.
Case Report:
We report a 70 year-old man with akinetic mutism due to bilateral ACA infarction. Electroencephalography, 24h after admission, showed bilateral independent periodic lateralized epileptiform discharges (BIPLEDs) in the frontal region and diffuse theta and polymorphic delta activity.
Discussion:
Postanoxic encephalopathy, central nervous system infection and chronic seizure disorders are the major causes of BIPLEDs. However, BIPLEDs may occur in bilateral ACA territory infarction.