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Periodic Lateralized Epileptiform Discharges (PLEDs) and pneumococcal meningoencephalitis

Jose Manuel Pardal-Fernández1, Maria Bengoa, Maria Carmen Carrascosa-Romero

  • 1Department of Neurophysiology, University General Hospital, Albacete, Spain. josempardal@yahoo.es

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|May 15, 2012
PubMed

Insights

Pneumococcal meningoencephalitis (PME) in children can cause Periodic Lateralized Epileptiform Discharges (PLEDs). Early diagnosis and treatment led to a full recovery, highlighting PME as a treatable cause of PLEDs.

Area of Science:

  • Neurology
  • Pediatrics
  • Infectious Diseases

Background:

  • Pneumococcal meningoencephalitis (PME) is a severe central nervous system (CNS) infection.
  • Periodic Lateralized Epileptiform Discharges (PLEDs) are an EEG pattern often seen in acute brain injuries, typically herpetic encephalitis in children.
  • Herpetic encephalitis has high morbidity and mortality rates.

Observation:

  • A 3-year-old girl with a bilateral ear infection developed seizures and coma.
  • Electroencephalography (EEG) revealed early PLEDs lateralized to the right.
  • Microbiological tests confirmed Streptococcus pneumoniae infection, ruling out herpetic encephalitis.

Findings:

  • This case describes the first known association of PME with PLEDs in a pediatric patient.
  • The patient showed significant improvement with intensive antibiotic and antiepileptic therapy.
  • Continuous EEG monitoring may be valuable in managing CNS infections.

Implications:

  • Non-herpetic CNS encephalitis, such as PME, should be considered in the differential diagnosis for PLEDs in children.
  • Early EEG evaluation and monitoring can aid in diagnosing and managing CNS infections.
  • Prompt treatment of PME can lead to favorable outcomes, contrasting with herpetic encephalitis.

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