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SPECT in periodic lateralized epileptiform discharges (PLEDs): a form of partial status epilepticus?

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  • 2001-07-24
Published in:
  • Seizure. - 2001
Aged
Aged, 80 and over
Brain
Cerebrovascular Circulation
Electroencephalography
Female
Functional Laterality
Humans
Male
Middle Aged
Occipital Lobe
Parietal Lobe
Periodicity
Radiopharmaceuticals
Retrospective Studies
Status Epilepticus
Technetium Tc 99m Exametazime
Temporal Lobe
Tomography, Emission-Computed, Single-Photon
English Periodic lateralized epileptiform discharges (PLEDs) are a well defined electroencephalographic entity but whether PLEDs represent an ictal condition or not remains debated. Much work has been done using electroencephalography (EEG) but new approaches using cerebral perfusion imaging may give more information about this question. We aimed to evaluate if PLEDs were associated with high regional cerebral blood flow (rCBF). We studied 18 patients with PLEDs and different pathologies, and performed brain single-photon-emission computed tomography (SPECT) during and, for three cases, after the disappearance of PLEDs. Qualitative variations and locations of rCBF were compared with PLEDs. Association with seizures and type of seizures were also assessed. SPECT showed high rCBF in 18/18 patients (100%). The location of PLEDs and high rCBF matched in 17/18 cases (94%). In the three cases where SPECT was performed after PLEDs disappeared, the high rCBF had cleared (100%). Eighteen cases (100%) presented seizures before recording of PLEDs, mainly motor (partial motor or generalized tonic-clonic). Where there was a decreased rCBF (related to a lesion) there was little relationship to PLEDs and all patients with decreased rCBF had an adjacent increased rCBF. These results confirm preliminary case reports. Hyperperfusion adds further to the argument that PLEDs may be related to a form of partial status epilepticus.
Language
  • English
Open access status
green
Identifiers
Persistent URL
https://fredi.hepvs.ch/global/documents/82781
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