Department of Neurology, University of Illinois Medical Center, Chicago, IL 60612, USA.
Epilepsy Behav. 2010 Jul;18(3):162-5. doi: 10.1016/j.yebeh.2010.04.047. Epub 2010 May 31.
The goal of this report is to review periodic lateralized epileptiform discharges (PLEDs), particularly their associated symptoms, the possibility that the pattern represents a focal status epilepticus, and finally the usefulness of antiepileptic drugs (AEDs). The associated symptoms often include an "altered state of consciousness" or "confusional state," but also more specific symptoms have been noted, such as nystagmus retractorius, cortical blindness, depression, apraxia, amnesia, hemianopsia, hemiparesis, gaze preference or deviation, dysphasia, and speech impediment. PLEDs have often been referred to as an ictal pattern, and many investigators have viewed the condition an example of subclinical status epilepticus. The intense hypermetabolism and increased blood flow revealed by PET and SPECT scans have been considered to support the ictal nature of this waveform. Although the pattern is difficult to treat, the AEDs that have been reported as successful include carbamazepine, midazolam, pentobarbital, sodium valproate, and felbamate. As only subtle symptoms are, at times, present and therefore may be missed and the pattern is known to be difficult to treat, epileptologists who view the PLED pattern as only an EEG curiosity and decide against treatment may wish to reevaluate the electroclinical evidence related to this interesting and significant pattern.
本报告的目的是回顾周期性偏侧性癫痫样放电（PLED），特别是其相关症状、该模式是否代表局灶性癫痫持续状态的可能性，以及最后是抗癫痫药物（AED）的作用。相关症状通常包括“意识改变”或“意识模糊”，但也有更具体的症状被注意到，如眼球回缩性震颤、皮质盲、抑郁、失用症、遗忘症、偏盲、偏瘫、凝视偏好或偏斜、构音障碍和言语障碍。PLED 常被称为发作模式，许多研究人员认为这种情况是亚临床癫痫持续状态的一个例子。PET 和 SPECT 扫描显示的强烈代谢亢进和血流量增加被认为支持这种波形的发作性质。尽管这种模式很难治疗，但已报道成功的 AED 包括卡马西平、咪达唑仑、戊巴比妥、丙戊酸钠和托吡酯。由于有时只有轻微的症状存在，因此可能会被遗漏，并且该模式已知难以治疗，因此将 PLED 模式仅视为 EEG 好奇心而不进行治疗的癫痫学家可能希望重新评估与这种有趣且重要模式相关的电临床证据。
