Pohlmann-Eden B, Hoch D B, Cochius J I, Chiappa K H
Department of Neurology, Mannheim Hospital, University of Heidelberg, Germany.
J Clin Neurophysiol. 1996 Nov;13(6):519-30. doi: 10.1097/00004691-199611000-00007.
It is the purpose of this review to critically consider and organize the literature dealing with the ephemeral electroencephalographic (EEG) pattern periodic lateralized epileptiform discharges (PLEDs). Although the retrospective nature of these studies limits their ability to discuss accurately the clinical and pathophysiological aspects of this EEG entity, the available data strongly emphasize stroke as the dominant etiology and its high association with seizures. Recent evidence, particularly from functional neuroimaging studies, strongly suggests that PLEDs might reflect a key pattern for focal hyperexcitability in the penumbra zone of ischemic stroke. The authors prefer to consider PLEDs as an EEG signature of a dynamic pathophysiological state in which unstable neurobiological processes create an ictal-interictal continuum, with the nature of the underlying neuronal injury, the patient's preexisting propensity to have seizures, and the co-existence of any acute metabolic derangements all contributing to whether seizures occur or not. This review underlines the need for further sophisticated prospective controlled studies implementing early continuous EEG monitoring in order to contribute to an understanding of the incidence, dynamics, and relevance of this pattern.
本综述旨在批判性地审视和整理有关短暂性脑电图（EEG）模式——周期性一侧性癫痫样放电（PLEDs）的文献。尽管这些研究的回顾性特点限制了它们准确讨论这种EEG现象的临床和病理生理方面的能力，但现有数据强烈强调中风是主要病因，且与癫痫发作高度相关。最近的证据，特别是来自功能神经影像学研究的证据，强烈表明PLEDs可能反映了缺血性中风半暗带区域局灶性过度兴奋的关键模式。作者倾向于将PLEDs视为一种动态病理生理状态的EEG特征，在这种状态下，不稳定的神经生物学过程形成了发作期与发作间期的连续体，潜在神经元损伤的性质、患者既往的癫痫发作倾向以及任何急性代谢紊乱的共存，都对癫痫发作是否发生有影响。本综述强调需要进行进一步复杂的前瞻性对照研究，实施早期连续EEG监测，以有助于理解这种模式的发生率、动态变化及相关性。
