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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.
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.
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.
- 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.