Harvard Medical School, Boston, Massachusetts, USA.
Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Prim Care Companion CNS Disord. 2020 Apr 9;22(2):19br02564. doi: 10.4088/PCC.19br02564.
Lateralized periodic discharges (LPDs) are a rare type of epileptiform activity. The authors of this brief report describe the association of LPDs with acute catastrophic depression in a previously healthy patient who had a series of neurobiological insults caused by a stroke and its treatment that led to the development of significant psychopathology. Through this case of new and debilitating depression that followed a recent stroke, subsequent development of LPDs, and treatment with levetiracetam, the authors highlight the complex interplay of structural, electrophysiologic, and pharmacologic factors in the pathogenesis of poststroke depression and the crucial role of having a broad biopsychosocial assessment for optimal diagnosis and management.
局灶性周期性放电（LPDs）是一种罕见的癫痫样活动。本文作者描述了一例先前健康的患者，在一系列由中风及其治疗引起的神经生物学损伤后，出现 LPDs 与急性灾难性抑郁的关联，这些损伤导致了明显的精神病理学。通过这例近期中风后新发的、使人虚弱的抑郁病例，随后出现的 LPDs 以及左乙拉西坦的治疗，作者强调了结构性、电生理学和药理学因素在中风后抑郁发病机制中的复杂相互作用，以及进行广泛的生物心理社会评估以进行最佳诊断和管理的重要性。
