The significance of periodic lateralized epileptiform discharges in EEG: An electrographic, clinical and pathological study

Chatrian, Gian Emilio; Shaw, Cheng‐Mei; Leffman, Henry

doi:10.1016/0013-4694(64)90149-x

Cited by 390 publications

(242 citation statements)

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“…Periodic lateralized epileptiform discharges (PLEDs) is a relatively uncommonEEGphenomenon consisting of periodic or quasi-periodic spikes or sharp waves, occurring at 1-2 second intervals in association with structural brain lesions (3). Weencountered a patient with epileptic dysphasia accompanied by PLEDson the EEG.…”

Section: Introductionmentioning

confidence: 99%

Dysphasia Accompanied by Periodic Lateralized Epileptiform Discharges.

et al. 1997

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Weencountered a 67-year-old man who presented with repetitious dysphasia accompanied by periodic lateralized epileptiform discharges (PLEDs) on the electroencephalogram.A good correlation was established between the dysphasia and the PLEDs.A persistent partial seizure accompanied by PLEDs originating in the left hemisphere presented with dysphasia clinically. None of the previously reported patients with epileptic dysphasia had accompanying PLEDs. The administration of carbamazepinewas successful to terminate the seizure, howevervalproate was not. This case indicates that PLEDsmay produce significant, however reversible, functional damage, and may advance our understanding of the pathophysiology of epileptic dysphasia. (Internal Medicine 36: 59-61, 1997)

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Section: Introductionmentioning

confidence: 99%

Dysphasia Accompanied by Periodic Lateralized Epileptiform Discharges.

et al. 1997

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“…The first description was a consistent increase in the amplitude of periodic epileptiform lateralized discharges (PLEDs) as an effect of painful stimuli 6 . The same paper also describes a patient who had numerous …”

Section: The Beginningmentioning

confidence: 99%

Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs): an intriguing EEG phenomenon

Silveira

Andrade

Garzón

2013

Arq. Neuro-Psiquiatr.

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AbSTRACT:SIRPIDs, an acronym for stimulus-induced rhythmic, periodic, or ictal discharges, were first named in 2004. This is a pattern observed in continuous electroencephalogram (CEEG) consistently elicited by stimulation in comatose patients. The pathophysiology of SIRPIDs probably involves dysregulation of subcortico-cortical projections, particularly thalamocortical circuit, in a markedly abnormal brain with hyperexci table cortex. This may explain some studies found an association of prolonged periodic epileptiform discharges (PEDs) activity and a higher incidence of concurrent electrographic seizures and SIRPIDs. An association of SIRPIDs and poor prognosis has already been described. However, it is not yet possible to assert whether these discharges can cause neuronal injury or if they are simply a marker of severe brain injury. Objective of this paper is to review clinical relevance and pathophysiology of SIRPIDs, as well as its role as a brain response in the critically ill patient.

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F ourteen years after Cobb and Hill 1 first applied the term 'periodic' to characteristic electroencephalographic (EEG) changes, in 1950, Chatrian et al 2 identified a periodic and lateralized pattern, which they described as periodic lateralized epileptiform discharges (PLEDs). The acronym encapsulates the essential characteristics of PLEDs, namely, wide distribution, polymorphism, one or more sharp components in a repetitive way (usually at the rate of one to two seconds), and localization over the hemisphere.

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confidence: 99%

“…Among the clinical manifestations, seizures are the most important and striking feature associated with PLEDs, occurring with a frequency from 58 to 100% 2,[8][9][10][11] . This wide range probably reflects the heterogeneity of patient selection and study design.…”

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Periodic electroencephalographic patterns: usefulness of definition and classification

Garzón¹

2012

Arq. Neuro-Psiquiatr.

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F ourteen years after Cobb and Hill 1 first applied the term 'periodic' to characteristic electroencephalographic (EEG) changes, in 1950, Chatrian et al. 2 identified a periodic and lateralized pattern, which they described as periodic lateralized epileptiform discharges (PLEDs). The acronym encapsulates the essential characteristics of PLEDs, namely, wide distribution, polymorphism, one or more sharp components in a repetitive way (usually at the rate of one to two seconds), and localization over the hemisphere. Subsequent studies have described other variable periodic patterns as two independent PLED types in the same EEG (BIPLEDs), multifocal PLEDs, generalized periodic epileptiform discharges (GPEDs), and stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) [3][4][5][6] .PLEDs are usually observed in the context of acute, large, and destructive cortical processes, such as hemispheric stroke, supratentorial tumor, or encephalitis. Corresponding widespread lesions are thought to lead to a marginal zone of cortical hyperexcitability that serves as the 'pacemaker' for a spatially extended, synchronous EEG discharge 7 . Neuroimaging findings have demonstrated that while an acute cortical lesion is the most common structural substrate of PLEDs, subcortical lesions, chronic lesions, and nonlesional scans are not uncommon 7 . The spatially variable nature of brain lesions in PLEDs could point to their origin in variable segments of a cortical and subcortical ' system', assuming that it -whatever its precise components are -comprises a large-scale interconnected network, prone to synchronous oscillation springing from injury to any component 7 .Despite the frequent use of the term periodic, little attention has been paid to, or agreement reached on, how periodicity is defined or how the term should be used with respect to EEG phenomena. It has been suggested that the rate for a given patient should not vary more than 20% 8 . However, the method of measurement, the number of intervals that should be measured, and the putative clinical relevance of this value have not been discussed.Most of these studies were retrospective, with EEGs being performed at arbitrary and widely varying time points in the course of the disease, with detailed information about these variables being provided in only a few instances. The importance of EEG timing in the detection of epileptiform abnormalities has not been generally appreciated, despite the fact that at least one study has clearly demonstrated that the incidence of periodic EEG patterns increases when they are performed earlier in the course of the disease process 8,9 .Among the clinical manifestations, seizures are the most important and striking feature associated with PLEDs, occurring with a frequency from 58 to 100% 2,[8][9][10][11] . This wide range probably reflects the heterogeneity of patient selection and study design. Focal motor seizures are usually seen in this clinical setting, often presenting as status epilepticus (epilepsia partialis continua) or as ...

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The significance of periodic lateralized epileptiform discharges in EEG: An electrographic, clinical and pathological study

Cited by 390 publications

References 24 publications

Dysphasia Accompanied by Periodic Lateralized Epileptiform Discharges.

Dysphasia Accompanied by Periodic Lateralized Epileptiform Discharges.

Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs): an intriguing EEG phenomenon

Periodic electroencephalographic patterns: usefulness of definition and classification

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