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- Title
Neuroimaging and Neurophysiology of Periodic Lateralized Epileptiform Discharges: Observations and Hypotheses.
- Authors
Kalamangalam, Giridhar P.; Diehl, Beate; Burgess, Richard C.
- Abstract
Purpose: We assessed neuroimaging lesion type and distribution in patients with periodic lateralized epileptiform discharges (PLEDs), with a view to identifying electrographic differences between PLEDs associated with differing lesion locations. Our observations led us to consider a conceptual synthesis between PLEDs and periodic complexes (PCs). Methods: Retrospective review of acute neuroimaging results (CT/MRI) on patients identified to have EEG PLEDs, for the period 1999–2003 (n = 106). Blinded classification of original EEG recordings. Results: Neuroimaging abnormalities were classified as acute or chronic cortical, or acute or chronic subcortical. Seven out of 106 scans were classified nonlesional. Overall ∼70% of scans had cortical abnormalities, whether acute or chronic; ∼23% had subcortical abnormalities. “Cortical” PLEDs were significantly longer in duration (p < 0.05) and more variable in morphology (p < 0.01) than “subcortical” PLEDs. Conclusions: Structural brain disease commonly, but not invariably, underlies PLEDs; lesion type is spatiotemporally variable. Cortical and subcortical PLEDs have distinct EEG signatures. There is evidence that these may relate to mechanisms for other pathological large-scale oscillatory brain synchronies (e.g., PCs).
- Subjects
EPILEPSY; BRAIN imaging; NEUROPHYSIOLOGY; MEDICAL imaging systems; ELECTROENCEPHALOGRAPHY
- Publication
Epilepsia (Series 4), 2007, Vol 48, Issue 7, p1396
- ISSN
0013-9580
- Publication type
Article
- DOI
10.1111/j.1528-1167.2007.01048.x