Trifocal independent periodic lateralized epileptiform discharges.

The EEG of a 2 1/2-year-old female with a severe cerebral insult showed trifocal periodic lateralized epileptiform discharges (TRIPLEDs). We believe this is the first such record reported. As with BIPLEDs, the physical findings associated with this EEG appear to represent a diffuse cerebral insult. The most frequent causes of BIPLEDs are diffuse anoxic encephalopathy and CNS infection. In this patient, the TRIPLEDs are apparently due to a severe anoxic insult suffered in utero. As is true with BIPLEDs, the presence of TRIPLEDs represents a poor prognosis.