Takagaki Kentaroh, Morales Megan K, Vitantonio Daniel, Berkowitz Frank, Bell William L, Kumar Princy N, Motamedi Gholam K
Department of Neurology, Georgetown University Hospital, Washington, DC, USA Department of Systems Physiology of Learning, Leibniz Institute for Neurobiology, Magdeburg, Germany.
Department of Medicine, Division of Infectious Disease and Travel Medicine, Georgetown University Hospital, Washington, DC, USA.
Clin EEG Neurosci. 2016 Jul;47(3):247-50. doi: 10.1177/1550059414552704. Epub 2014 Oct 17.
Periodic lateralized epileptiform discharges (PLEDs) are an electroencephalographic pattern recorded in the setting of a variety of brain abnormalities. It is best recognized for its association with acute viral encephalitis, stroke, tumor, or latestatus epilepticus. However, there are other conditions that have been recognized as the underlying pathology for PLEDs such as alcohol withdrawal, Creutzfeldt-Jacob disease, anoxic brain injury, and hemiplegic migraine. However, there are only rare case reports of PLEDs in patients with neurosyphilis. Here, we report 2 patients presenting with encephalopathy and seizures with PLEDs, ipsilateral or contralateral to their main brain magnetic resonance imaging abnormalities. Further workup revealed neurosyphilis in both patients, one in association with human immunodeficiency virus (HIV) infection. Given the increasing incidence of neurosyphilis with or without HIV infection, these cases suggest neurosyphilis as a consideration in the differential for patients presenting with PLEDs.
周期性一侧性癫痫样放电（PLEDs）是在多种脑异常情况下记录到的一种脑电图模式。它因其与急性病毒性脑炎、中风、肿瘤或癫痫持续状态的关联而最为人所熟知。然而，还有其他一些情况被认为是PLEDs的潜在病理基础，如酒精戒断、克雅氏病、缺氧性脑损伤和偏瘫性偏头痛。然而，神经梅毒患者出现PLEDs的病例报告极为罕见。在此，我们报告2例出现脑病和癫痫发作并伴有PLEDs的患者，PLEDs位于其主要脑磁共振成像异常的同侧或对侧。进一步检查发现两名患者均患有神经梅毒，其中一名与人类免疫缺陷病毒（HIV）感染有关。鉴于神经梅毒在有或无HIV感染情况下的发病率不断上升，这些病例提示神经梅毒应作为伴有PLEDs患者鉴别诊断时的考虑因素。
