Department of Neurology, Montefiore Medical Center, Bronx, NY 10467, USA.
Clin EEG Neurosci. 2010 Jan;41(1):11-4. doi: 10.1177/155005941004100104.
Periodic lateralized epileptiform discharges (PLEDs), an EEG pattern that is highly correlated with seizures, may represent an ictal pattern in some patients, but in other patients PLEDs persist despite the absence of seizures or after seizures have been controlled by anti-epileptic drugs. The tenacity of PLEDs was illustrated by continuous EEG recording in a 95-year-old woman with multiple old cerebral infarctions who had been admitted to the hospital because of seizures. The EEG showed PLEDs that were maximal in the left central region. These sometimes evolved into EEG seizure patterns, which were correlated with facial twitching. The seizures were controlled by anti-epileptic drugs (AEDs), but the PLEDs continued. The patient subsequently expired, with EEG monitoring still in progress. The PLEDs persisted as the patient developed agonal respirations. The interval between the epileptiform complexes gradually increased, and they stopped 40 seconds before disappearance of the other EEG background rhythms; cardiac arrest ensued less than 1 minute later. The resistance of the PLEDs to hypoxia reflects the robustness of the mechanisms that produced them, which may also account for their persistence in the face of AED treatment that stopped the seizures.
周期性偏侧性癫痫样放电 (PLEDs) 是一种与癫痫高度相关的 EEG 模式，在某些患者中可能代表发作模式，但在其他患者中，尽管没有癫痫发作或癫痫发作已被抗癫痫药物控制，PLEDs 仍持续存在。一位 95 岁的女性患者因癫痫发作住院，她有多次陈旧性脑梗死，其连续 EEG 记录说明了 PLEDs 的顽固性。脑电图显示左中央区域的 PLEDs 最大。这些 PLEDs 有时会演变成与面部抽搐相关的 EEG 发作模式。癫痫发作通过抗癫痫药物 (AED) 得到控制，但 PLEDs 仍持续存在。患者随后去世，脑电图监测仍在进行。当患者出现濒死性呼吸时，PLEDs 持续存在。癫痫样波群之间的间隔逐渐增加，它们在其他 EEG 背景节律消失前 40 秒停止；不到 1 分钟后心脏骤停。PLEDs 对缺氧的抵抗力反映了产生它们的机制的稳健性，这也可能解释了它们在面对停止癫痫发作的 AED 治疗时仍持续存在的原因。
