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Related Experiment Videos

Gaze deviation from contralateral pseudoperiodic lateralized epileptiform discharges (PLEDs).

Peter W Kaplan1

  • 1Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224, USA. pkaplan@jhmi.edu

Epilepsia
|June 11, 2005
PubMed
Summary

Pseudoperiodic lateralized epileptiform discharges (PLEDs) can cause gaze deviation in awake patients, even without seizures. This finding highlights PLEDs as a potential cause of "positive" neurologic signs, not just negative ones.

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Area of Science:

  • Neurology
  • Clinical Neurophysiology

Background:

  • Pseudoperiodic lateralized epileptiform discharges (PLEDs) are typically associated with negative neurologic findings.
  • Seizures often cause positive clinical manifestations due to cortical activation.
  • Gaze deviation can result from damage to frontal eye fields (FEFs) or during focal seizures.

Observation:

  • A patient with prior right cerebral infarctions presented with leftward gaze preference and deviation while alert.
  • Electroencephalography (EEG) revealed PLEDs in the right fronto-central region without electrographic seizures.
  • The patient's gaze deviation was the primary clinical feature observed.

Findings:

  • PLEDs, even without concurrent seizures, can excite frontal regions near the FEFs.
  • This excitation can lead to contraversive gaze preference in awake individuals.

Related Experiment Videos

  • Gaze deviation can be a direct clinical manifestation of PLEDs.

    • Implications:

    • This case expands the understanding of PLEDs, demonstrating they can produce positive neurologic signs.
    • It suggests a mechanism for gaze deviation independent of overt seizures.
    • Highlights the importance of considering PLEDs in the differential diagnosis of gaze abnormalities.