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Periodic epileptiform discharges in the midline

B F Westmoreland1, R C Frere, D W Klass

  • 1Division of Clinical Neurophysiology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|February 11, 1998
PubMed
Summary

Periodic epileptiform discharges in the midline (PEDIM) were observed in five patients experiencing partial motor seizures. This EEG activity correlated with cerebrovascular insults, suggesting a parasagittal origin.

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Area of Science:

  • Neurology
  • Neurophysiology
  • Epileptology

Background:

  • Periodic lateralized epileptiform discharges (PLEDs) are associated with acute brain injury.
  • Midline EEG abnormalities are less commonly described than PLEDs.

Purpose of the Study:

  • To describe a novel EEG finding: periodic epileptiform discharges in the midline (PEDIM).
  • To correlate PEDIM with clinical presentation and neuroimaging findings.

Main Methods:

  • Case series of five patients with PEDIM.
  • Electroencephalography (EEG) analysis.
  • Clinical seizure pattern and neurological deficit assessment.

Main Results:

  • All five patients exhibited PEDIM on EEG.

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  • All patients presented with acute partial motor seizures affecting the lower extremity.
  • PEDIM location corresponded to seizure type and focal deficits.
  • All patients had a history of cerebrovascular insult.
  • Findings suggest an origin in the parasagittal watershed area.

    • Conclusions:

    • PEDIM is a distinct EEG pattern associated with specific clinical features.
    • PEDIM may indicate a cerebrovascular insult in the parasagittal region.
    • This finding expands the understanding of EEG abnormalities in cerebrovascular disease.