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Periodic lateralized epileptiform discharges in multiple sclerosis
D R Chabolla1, J L Moore, B F Westmoreland
1Division of Clinical Neurophysiology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Electroencephalography and Clinical Neurophysiology
|January 1, 1996
Summary
Multiple sclerosis exacerbations can trigger complex partial status epilepticus and periodic lateralized epileptiform discharges (PLEDs) in young adults. These PLEDs resolve within two weeks, linked to white matter lesions.
Area of Science:
- Neurology
- Neurophysiology
- Neuroimmunology
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system.
- Seizures are a known neurological complication of MS, but their specific electroencephalographic (EEG) manifestations can vary.
- Periodic lateralized epileptiform discharges (PLEDs) are typically associated with acute focal brain injury.
Observation:
- A young male patient with a history of MS experienced two episodes of complex partial status epilepticus separated by three years.
- Following each status epilepticus episode, serial EEGs demonstrated PLEDs, initially right frontal and later right frontotemporal and bifrontal.
- Magnetic resonance imaging (MRI) revealed an enhancing white matter lesion in the right frontal lobe during the first episode, which showed improvement over time.
Findings:
- The study identified exacerbations of MS as an unusual cause of PLEDs.
- The PLEDs observed in this patient resolved spontaneously within two weeks after each seizure episode.
- The occurrence of PLEDs correlated with MS exacerbations and associated focal brain lesions.
Implications:
- This case highlights the importance of considering MS exacerbations in the differential diagnosis of PLEDs, especially in patients with a known history of the disease.
- Understanding the link between MS activity and specific EEG patterns like PLEDs can aid in diagnosis and management.
- Further research may elucidate the mechanisms by which MS exacerbations lead to acute epileptiform activity.