[A case of epilepsy presenting periodic synchronous discharges and recruiting rhythm for a long time]

A case of secondary generalized epilepsy (47 years old, male) presenting the periodic synchronous discharges (PSD) consisted of sharp waves or sharp and slow waves, and recruiting rhythm (RR) for several years was shown. PSD, of which duration was 10-40 sec, was seen most prominently when he was awake and relaxed, although it was also found during both wakefulness and sleep. On the other hand, RR with a duration of 1-5 sec was observed only during NREM sleep (stage 2 and 3). There was no clinical manifestation associated with PSD and RR, except for the eye-opening behaviors occasionally seen during RR. From the electroencephalographic features of PSD and RR, and the other previous reports concerning them, it was speculated that an association of diffuse cortical and brain stem dysfunctions was responsible for both PSD and RR. In addition, the similarity and dissimilarity of PSD and RR with the slow spike and wave complex and rapid rhythm chiefly seen in the Lennox-Gastaut syndrome were discussed. It was stressed that whether the slow spike and wave complex and rapid rhythm were specifically related to the Lennox-Gastaut syndrome should be reappraised.