[Recurrent confusional states and periodic lateralized epileptiform discharges: a new type of non-convulsive status...

Periodic lateralized epileptiform discharges (PLEDs) in an EEG usually indicate the presence of an underlying structural lesion (of vascular origin in most cases). PLEDs are also sometimes observed in certain types of infections (mainly viral), in which they may even constitute a characteristic finding useful for diagnostic purposes. In recent years cases have been reported in which PLEDs are linked to recurring confusional states that do not fit in with established classifications and that may be epileptic in nature. We discuss the cases of 2 patients who were repeatedly admitted to our hospital in confusional states, in whom PLEDs were observed in EEG readings. Clinical evolution in both cases paralleled EEG alterations. We were able to perform both critical and intercritical single proton emission tomography on 1 patient, finding, respectively, hyper- and hypoabsorption foci. Symptoms resolved with antiepileptic treatment.