Periodic lateralized epileptiform discharges (PLEDs) in cerebral lupus correlated with white-matter lesions in brain MRI and reduced cerebral blood flow in SPECT.
This is a case report on an uncommon correlation between periodic lateralized epileptiform discharges (PLEDs) and white-matter lesions in cerebral lupus, and with a reduced cerebral blood flow (CBF) in single-photon emission computed tomography (SPECT). A 47-year-old woman with a long-term history of systemic lupus erythematosus (SLE) presented with a seizure followed by frontal lobe dysfunction clinically. An electroencephalogram (EEG) showed bilateral independent PLEDs in the frontal region. A magnetic resonance image of the brain showed white-matter changes in the frontal periventricular region. Cerebral angiogram did not reveal any evidence of vasculitis. A cerebral SPECT with tracer injected during the EEG showing PLEDs showed a reduction in CBF in the frontal regions. Clinical recovery was observed with intravenous immunoglobulin. This case shows that PLEDs can be seen with white-matter changes in SLE.
Division of Neurology, Faculty of Medicine, University of Malaya, Malaysia.
S M M
SM
Aye
K S
KS
Lim
N M
NM
Ramli
C T
CT
Tan
D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012640:Seizures / Q000000981:diagnostic imaging / Q000209:etiology*; D015899:Tomography, Emission-Computed, Single-Photon