Periodic lateralized epileptiform discharges as manifestation of pneumococcal meningoencephalitis

Fernández, Francisco Sousa; Fernández-Díaz, Eva; Pardal-Fernández, José Manuel; Segura, Tomás; García-García, Jorge

doi:10.1186/1755-7682-4-23

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…PDs do not constitute a specific pattern of neurological disease ( 13 ). Associations between PDs and seizure have been studied in critically ill adult patients ( 1 , 4 ).…”

Section: Discussionmentioning

confidence: 99%

Can Spectral Power Be Used as a Candidate Seizure Marker of the Periodic Discharges Pattern?

et al. 2021

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Introduction: It remains controversial whether the periodic discharges (PDs) pattern is an ictal or interictal phenomenon. The aims of the study are to apply time-frequency and power spectrum analysis to study the PDs pattern and prediction of seizures.Methods: We retrospectively searched continuous electroencephalography (cEEG) recordings to identify patients exhibiting the PDs pattern. Artifact-free cEEG segments demonstrating the PDs pattern with stable baselines were chosen for time-frequency and power spectrum analysis.Results: In total, 72 patients (1.3%) exhibited the PDs pattern, with a mean age 36.0 ± 20.7 years (range, 8–76 years). The median spectral power of PDs with a length of 60 s was 70.94 μV2 and that of PDs with a length of 20 s was 195.80 μV2. During follow-up, patients with spectral power of PDs of length 60 and 20 s lower than 28.65 and 36.09 μV2, respectively, exhibited no seizure. For predicting seizures, when the spectral power for PDs of 60 and 20 s equaled to 17.26 and 21.40 μV2, respectively, the diagnostic sensitivity was 100% and specificity was 86%. The locations of maximal spectral power of PDs, crude seizure onset zone (SOZ) judged from scalp EEG, and the most prominent regions of hyper- or hypo-metabolism on FDG-PET were congruent.Conclusions: Spectral power might be a candidate seizure marker of the PDs pattern. High spectral power predicted a high risk of seizures, and low spectral power was associated with a low risk of seizures.

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“…PDs do not constitute a specific pattern of neurological disease ( 13 ). Associations between PDs and seizure have been studied in critically ill adult patients ( 1 , 4 ).…”

Section: Discussionmentioning

confidence: 99%

Can Spectral Power Be Used as a Candidate Seizure Marker of the Periodic Discharges Pattern?

et al. 2021

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“…LPDs are frequently associated with acute, structural brain lesion; very often with Ischemic stroke, viral encephalitis, including autoimmine encephalitis [10], tumors, intracerebral hemorrage (ICH) [11], Anoxic encephalopathy, Creutzfeldjacob disease CJD [12], Subarachnoid Hemorrage (SAH) [13], Multiple Sclerosis (MS), Posterior Reversible Encephalopathy Syndrome (PRES) ( Figure 3); they have been also reported in Migraine headache, Mitochondrial Encephalopathy with lactic acidosis and stroke like episodes, (MELAS).…”

Section: Etiologymentioning

confidence: 99%

Periodic EEG Patterns in the Intensive Care Unit (ICU): Definition, Recognition and Clinical Significance

Mesraoua¹,

Ali²,

Khodair³

et al. 2021

Electroencephalography - From Basic Research to Clinical Applications

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Periodic electroencephalographic (EEG) patterns are frequently recorded during ICU EEG monitoring in patients with altered mental status; these EEG features represent electrical discharges, ictal in appearance, occuring at regular intervals. They are known as lateralized periodic discharges (LPDs), bilateral independent periodic discharges (BIPDS), generalized periodic discharges (GPDs), continuous 2/s GPDs with triphasic morphology or triphasic waves (TWs) and Stimulus Induced Evolving Lateralized Rhytmic delta activity or Si-Evolving LRDA (previously SIRPIDS); other periodic, rhythmic patterns are Occasional frontally predominant brief 2/s GRDA (FIRDA previously), Lateralized rhythmic delta activity (LRDA) and Brief potentially ictal rhythmic discharges or B (I)RDs. The role of most (not all) of these EEG patterns is controversial; there is no consensus on which patterns are associated with ongoing seizure injury, which patterns need to be treated, and how aggressively they should be treated. Many authors consider these patterns as an unstable state on an ictal-interictal EEG continuum; the aim of the present chapter is to gain knowledge of these EEG features, show their association with known neurologic pathologies/syndromes and finally how to manage them.

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“…Interestingly, the models mentioned above closely align with earlier hypotheses which concluded that inter-discharge intervals (in the pattern structure) can reflect a long refractory period. The discharges themselves reflect a massive depolarization of neurons, which are repeatedly excited by unknown stimuli (Gloor et al, 1968;Hernández-Fernández et al, 2011). Glutamate is a suitable candidate for the role of such a stimulus.…”

Section: Physiological Substrates Of Periodicitymentioning

confidence: 99%

LPDs – «Linked to penumbra» discharges or EEG correlate of excitotoxicity: A review based hypothesis

Chegodaev

Pavlova

et al. 2020

Epilepsy Research

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Periodic lateralized epileptiform discharges (PLEDs) or lateralized periodic discharges (LPDs) are a well-known variant of pathological EEG activity. However, the mechanisms underpinning the appearance of this pattern are not completely understood. The heterogeneity of the features derived from LPDs patterns, and the wide range of pathological conditions in which they occur, raise a question about the unifying mechanisms underlying these phenomena. This paper reassesses the current opinion surrounding LPDs which considers glutamate excitotoxicity to be the primary pathophysiological basis, and the penumbral region to be the main morphological substrate. Arguments in favour of this hypothesis are presented, with interpretations supported by evidence from recent literature involving clinical and experimental data. Presently, no single hypothesis places considerable emphasis on the pathochemical properties of LPDs, which are implicitly meaningful towards better understanding of the clinical significance of this pattern.

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Periodic lateralized epileptiform discharges as manifestation of pneumococcal meningoencephalitis

Cited by 6 publications

References 11 publications

Can Spectral Power Be Used as a Candidate Seizure Marker of the Periodic Discharges Pattern?

Can Spectral Power Be Used as a Candidate Seizure Marker of the Periodic Discharges Pattern?

Periodic EEG Patterns in the Intensive Care Unit (ICU): Definition, Recognition and Clinical Significance

LPDs – «Linked to penumbra» discharges or EEG correlate of excitotoxicity: A review based hypothesis

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