The pathophysiological connection between periodic lateralized epileptiform discharges (
PLED) and epileptic
seizures is still not clear. In the study clinical data and EEG findings were analysed in 22 patients aged 43-90 years with a history of
stroke in whom EEG disclosed
PLED. Eleven patients were studied in the acute phase of
stroke and 11 were studied years after
stroke when the diagnosis was established of poststroke
epilepsy. In 2 patients in
acute stroke group single epileptic
seizures occurred and 5 had partial
status epilepticus. In the group with poststroke
epilepsy 4 had
single seizures and 4 had epileptic status with
partial epilepsy seizures. Thus, in 15 out of 22 patients PLEDs were noted after epileptic
seizures. In all cases
PLED appearance was connected with consciousness disturbances, lasting 1 to 17 days. In 6 cases
PLED pattern was interrupted by seizure activity over one hemisphere, in 3 of them partial epileptic
seizures were associated with it. In acute phase of
stroke neuroimaging demonstrated the presence of fresh ischaemic foci, but in cases of poststroke
epilepsy no such fresh foci were observed. These results suggest that
PLED frequently can be associated with
epilepsy, and in some patients it can be a bioelectrical manifestation of partial status epileptic.