Ictal sensory periodic lateralized epileptiform discharges

Area of Science:

• Neurology
• Epileptology
• Neuroimaging

Background:

• Arteriovenous malformations (AVMs) and radiation necrosis can lead to complex neurological symptoms.
• Periodic lateralized epileptiform discharges (PLEDs) are typically associated with focal neurological deficits or seizures.
• Sensory seizures are characterized by subjective sensory experiences without motor activity.

Observation:

• A 74-year-old male presented with persistent, subjective right-sided groin pulsations.
• The patient had a history of left parietal AVM and cerebral white matter radiation necrosis.
• Electroencephalography (EEG) demonstrated left parietal PLEDs synchronous with the reported sensations.

Findings:

• The patient's groin pulsations were confirmed as sensory seizures.
• The PLEDs were identified as the electrographic correlate of these sensory seizures.
• This represents the first documented case of ictal PLEDs manifesting as sensory seizures.

Implications:

• This case expands the understanding of PLEDs' clinical manifestations.
• It suggests a potential mechanism for sensory phenomena in patients with specific brain lesions.
• Highlights the importance of EEG in diagnosing rare seizure types.