Abstract
Periodic lateralized epileptiform discharges (PLEDs) are typically associated with encephalitis, cerebral abscess, cerebral infarct, and status epilepticus. There is considerable debate as to whether this pattern is ictal or interictal when seen in association with status epilepticus. We present a patient with complex partial status epilepticus who developed PLEDs and remained comatose despite optimal drug therapy. Technetium 99m single-photon emission computed tomography (SPECT) showed hyperperfusion that resolved with further aggressive antiepileptic drug therapy, indicating that this pattern may indeed be ictal. Further studies are needed to define the significance of PLEDs in patients with status epilepticus. The role of SPECT in differentiating PLEDs as an interictal or ictal pattern also requires further study.
MeSH terms
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Adenocarcinoma / secondary
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Adenocarcinoma / surgery
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Anticonvulsants / administration & dosage
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Brain Neoplasms / secondary
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Brain Neoplasms / surgery
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Dominance, Cerebral / drug effects
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Dominance, Cerebral / physiology*
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Electroencephalography / drug effects
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Epilepsy, Complex Partial / diagnosis
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Epilepsy, Complex Partial / drug therapy
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Epilepsy, Complex Partial / physiopathology*
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Female
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Humans
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Lung Neoplasms / surgery
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Middle Aged
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Parietal Lobe / drug effects
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Parietal Lobe / physiopathology
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Parietal Lobe / surgery
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Postoperative Complications / diagnosis
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Postoperative Complications / drug therapy
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Postoperative Complications / physiopathology
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Regional Blood Flow / drug effects
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Regional Blood Flow / physiology
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Status Epilepticus / diagnosis
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Status Epilepticus / drug therapy
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Status Epilepticus / physiopathology*
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Tomography, Emission-Computed, Single-Photon