FIG. 3. LPDs: Sharply contoured lateralized periodic discharges. In this case, PDs are bilateral asymmetric. Although some discharges are on the border of sharp, most are sharply contoured. FIG. 4. LPDs: 0.5 per second spiky lateralized periodic discharges.FIG. 5. LPDs: 0.5-1 per second spiky lateralized periodic discharges. Despite their spike-and-wave morphology, the discharges are periodic (as there is a quantifiable inter-discharge interval between consecutive waveforms and recurrence of the waveform at nearly regular intervals). FIG. 6. LPDs1F: 0.5 to 1 per second spiky LPDs with superimposed burst of low amplitude fast activity (highlighted in boxes). Hirsch LJ et al FIG. 7. LPDs1R: Irregular (in morphology and repetition rate) 0.5-1 per second quasi-periodic discharges with superimposed quasi-rhythmic delta activity in the right hemisphere with occasional spread to the left. Less "stable" pattern and more ictalappearing than LPDs alone; compare with Figure 1. FIG. 8. Fluctuating LPDs: Lateralized periodic discharges that fluctuate in frequency between 0.5 and 1 per second.

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Seizures and epilepsy are common sequelae of acute brain insults such as stroke, traumatic brain injury, and central nervous system infections. Early, or acute symptomatic, seizures occur at the time of the brain insult and may be a marker of severity of injury. A cascade of morphologic and biologic changes in the injured area over months to years leads to hyperexcitability and epileptogenesis. After a variable latency period, late unprovoked seizures and epilepsy occur. The latent period may offer a therapeutic window for the prevention of epileptogenesis and the development of unprovoked seizures and epilepsy. Administration of anticonvulsant drugs following acute brain insults has thus far failed to prevent late epilepsy. Proper choice of disease models and target populations will aid in the development of putative antiepileptogenic agents. The incidence, timing, and pathophysiology of common epileptogenic brain injuries, including head trauma, cerebrovascular disease, brain tumors, neurosurgical procedures, neurodegenerative conditions, status epilepticus, and febrile seizures, are reviewed.

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