Clinical significance of periodic lateralized epileptiform discharges in children with relation to level of consciousness.
Six children with acute cerebral insult, ranging in age from 3 days to 8 years, revealed periodic lateralized epileptiform discharges in their electroencephalographic recordings. Their etiologic factors were cerebral infarction, intracranial bleeding, purulent meningitis, acute infantile hemiplegia, and encephalitis. Each patient exhibited a different type of convulsive seizure. Computer tomography or magnetic resonance imaging revealed diffuse lesions covering the cerebral cortex and subcortical white matter in 2 patients, a lesion of the subcortical white matter in 1 patient, a linear lesion in the cortex and along the borderline between the cortex and the subcortical white matter in 1 patient, and localized lesions in the cortex and basal ganglia in 1 patient. There were findings indicating the disconnection of the cerebral cortex with deeper structures in 3 patients. The appearance rate of periodic lateralized epileptiform discharges increased at levels of consciousness from 5 to 7 on a pediatric modification of the Glasgow Coma Scale. At levels of consciousness from 8 to 14 and below 4, the rate was very low.
Hamano
K
K
Department of Pediatrics, University of Tsukuba, Ibaraki-ken, Japan.
Iwasaki
N
N
Takeya
T
T
Takita
H
H
D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D002648:Child; D003244:Consciousness Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003952:Diagnostic Imaging; D004292:Dominance, Cerebral / Q000502:physiology*; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004829:Epilepsy, Generalized / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009460:Neurologic Examination; D013036:Spasms, Infantile / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology