Descargas epileptiformes periódicas lateralizadas: 1. Aspectos clínicos e eletrencefalograficos

Bertolucci, Paulo H. F.; Silva, Ademir Baptista da

doi:10.1590/S0004-282X1987000400002

Resumos

Em período de dois anos, em 25 de um total de 5481 EEGs foi identificada a presença de descargas epileptiformes periódicas lateralizadas (PLEDs) (prevalência de 0,45%), correspondendo a 22 pacientes. O grupo era composto de 13 homens e 9 mulheres, com idade variando entre 5 meses e 85 anos. Os principais diagnósticos no grupo foram epilepsias de etiologia não identificada e tumor do cérebro (22% cada). A localização mais comum das PLEDs foi temporal (54% do total), principalmente temporal média. A morfologia mais freqüente das PLEDs foi onda delta trifásica (¹/3 do total), seguida por onda aguda bifásica e onda aguda-onda lenta (29% cada). Embora 9 dos pacientes tenham falecido, não foi possível determinar o valor prognóstico das PLEDs para cada patologia em particular.

In a two-years period, from a total of 5481 EEGs, we could select 25, corresponding to 22 patients, with PLEDs (prevalence of 0.45%). The group was composed by 13 males and 9 females, with age ranging from 5 months to 85 years. Main diagnosis was epilepsy of unknown etiology and brain tumor (22% each). The localization of PLEDs was mainly temporal region (54% of the whole group) and more frequent morphology was "delta triphasic wave" (a graphic pattern resembling sharp wave, but with longer duration) (Vz of total), followed by sharp biphasic wave and sharp wave-slow wave (29% each). Although 9 patients died it was not possible to determine prognostic value of PLEDs specifically for each pathological condition.

Descargas epileptiformes periódicas lateralizadas: 1. Aspectos clínicos e eletrencefalograficos

Periodic lateralized epileptiform discharges: I. Clinical and electroencephalographic features

Paulo H. F. Bertolucci; Ademir Baptista da Silva

Professor Adjunto - Trabalho realizado no Setor de Eletrencefalografia da Disciplina de Neurología da Escola Paulista de Medicina

RESUMO

Em período de dois anos, em 25 de um total de 5481 EEGs foi identificada a presença de descargas epileptiformes periódicas lateralizadas (PLEDs) (prevalência de 0,45%), correspondendo a 22 pacientes. O grupo era composto de 13 homens e 9 mulheres, com idade variando entre 5 meses e 85 anos. Os principais diagnósticos no grupo foram epilepsias de etiologia não identificada e tumor do cérebro (22% cada). A localização mais comum das PLEDs foi temporal (54% do total), principalmente temporal média. A morfologia mais freqüente das PLEDs foi onda delta trifásica (¹/₃ do total), seguida por onda aguda bifásica e onda aguda-onda lenta (29% cada). Embora 9 dos pacientes tenham falecido, não foi possível determinar o valor prognóstico das PLEDs para cada patologia em particular.

SUMMARY

In a two-years period, from a total of 5481 EEGs, we could select 25, corresponding to 22 patients, with PLEDs (prevalence of 0.45%). The group was composed by 13 males and 9 females, with age ranging from 5 months to 85 years. Main diagnosis was epilepsy of unknown etiology and brain tumor (22% each). The localization of PLEDs was mainly temporal region (54% of the whole group) and more frequent morphology was "delta triphasic wave" (a graphic pattern resembling sharp wave, but with longer duration) (Vz of total), followed by sharp biphasic wave and sharp wave-slow wave (29% each). Although 9 patients died it was not possible to determine prognostic value of PLEDs specifically for each pathological condition.

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Disciplina de Neurologia, Escola Paulista de Medicina - Rua Botucatu, 740 - 04023 -São Paulo, SP - Brasil.

1. ALAJOUANINE, T.; LECASBLE, R. & RÉMOND, A. - Eléments graphiques paroxystiques lents de survenue périodique: corrélations électrocliniques. Rev. neurol. (Paris) 93:477, 1955.
2. CHATRIAN, G.E. - An EEG pattern: pseudo-rhythmic recurrent sharp waves: its relationship to local cerebral anoxia and hypoxia. Electroenceph. clin. Neurophysiol. 13:144, 1961.
3. CHATRIAN, G.E.; SHAW, CM. & LEFFMAN, H. - The significance of periodic lateralized epileptiform discharges in EEG: an electrographic, clinical and pathological study. Electroenceph clin. Neurophysiol. 17:177, 1964.
4. DICKSON, J. - Unilateral periodic slow waves in relation to local cerebral lesions. Electroenceph. clin. Neurophysiol. 10:352, 1958.
5. ECHLIN, F.A. - The supersensitivity of chronically isolated cerebral cortex as a mechanism in focal epilepsy. Electroenceph. din. Neurophysiol. 11:697, 1959.
6. FISCHER-WILLIAMS, M. - Burst-suppression activity as an indication of undercut cortex. Electroenceph. clin. Neurophysiol. 15:723, 1963.
7. GACHES, J. - Activités périodiques en EEG. Rev. Electroencéphalogr. Neurophysiol. clin. 1:9, 1971.
8. HUGHES, J.B. & SCHLAGENHAUFF, R.E. - The periodically recurring focal discharge. Epilepsia 6:156, 1965.
9. LEBEAU, J. & DONDEY, M. - Importance diagnostique de certaines activités électroencéphalographiques latéralisées, périodiques ou à tendance périodique au cours des abcès du cerveau. Electroenceph. clin. Neurophysiol. 11:43, 1959.
10. LUGARESI, E. ; COCCAGNA, G.; MANTOVANI, M. & LEBRUN, R. - Some periodic phenomena arising during drowsiness and sleep in man. Electroenceph. clin. Neurophysiol. 32:701, 1972.
11. MARKAND, O.N. & DALY, D.D. - Pseudoperiodic lateralized paroxysmal discharges in electroencephalogram. Neurology 21:975, 1971.
12. MILLAR, J.H.D. & COEY, A. - The EEG in necrotizing encephalitis. Electroenceph. clin. Neurophysiol. 11:582, 1959.
13. MUSGRAVE, F.S.; SANAMAN, M. & PURPURA, D.P. - Factors affecting focal discharges of epileptogenic cortex. Physiologist 5:187, 1962.
14. PURPURA, D.P.; GOLDENSOHN, E.S. & MUSGRAVE, F.S. - Synaptic and nonsynaptic processes in focal epileptogenic activity. Electroenceph. clin. Neurophysiol. 15:1051, 1963.
15. SCHWARTZ, M.S.; PRIOR, P.F. & SCOTT, D.F. - The occurrence and evolution in the EEG of a lateralized periodic phenomenon. Brain 96:613, 1973.
16. van BOGAERT, L.; RADERMECKER, J. & DEVOS, J. - Sur une observation mortelle d'encéphalite aiguë nécrotissante. Rev. neurol. (Paris) 92:329, 1955.
17. van SWEDEN, B. & HOSTE, S. - Periodic EEG discharges in phychiatry. Eur. Neurol. 22:359, 1983.

Datas de Publicação

Publicação nesta coleção
22 Jun 2011
Data do Fascículo
Dez 1987

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALAJOUANINE, T.; LECASBLE, R. & RÉMOND, A. - Eléments graphiques paroxystiques lents de survenue périodique: corrélations électrocliniques. Rev. neurol. (Paris) 93:477, 1955.

[2] 2. CHATRIAN, G.E. - An EEG pattern: pseudo-rhythmic recurrent sharp waves: its relationship to local cerebral anoxia and hypoxia. Electroenceph. clin. Neurophysiol. 13:144, 1961.

[3] 3. CHATRIAN, G.E.; SHAW, CM. & LEFFMAN, H. - The significance of periodic lateralized epileptiform discharges in EEG: an electrographic, clinical and pathological study. Electroenceph clin. Neurophysiol. 17:177, 1964.

[4] 4. DICKSON, J. - Unilateral periodic slow waves in relation to local cerebral lesions. Electroenceph. clin. Neurophysiol. 10:352, 1958.

[5] 5. ECHLIN, F.A. - The supersensitivity of chronically isolated cerebral cortex as a mechanism in focal epilepsy. Electroenceph. din. Neurophysiol. 11:697, 1959.

[6] 6. FISCHER-WILLIAMS, M. - Burst-suppression activity as an indication of undercut cortex. Electroenceph. clin. Neurophysiol. 15:723, 1963.

[7] 7. GACHES, J. - Activités périodiques en EEG. Rev. Electroencéphalogr. Neurophysiol. clin. 1:9, 1971.

[8] 8. HUGHES, J.B. & SCHLAGENHAUFF, R.E. - The periodically recurring focal discharge. Epilepsia 6:156, 1965.

[9] 9. LEBEAU, J. & DONDEY, M. - Importance diagnostique de certaines activités électroencéphalographiques latéralisées, périodiques ou à tendance périodique au cours des abcès du cerveau. Electroenceph. clin. Neurophysiol. 11:43, 1959.

[10] 10. LUGARESI, E. ; COCCAGNA, G.; MANTOVANI, M. & LEBRUN, R. - Some periodic phenomena arising during drowsiness and sleep in man. Electroenceph. clin. Neurophysiol. 32:701, 1972.

[11] 11. MARKAND, O.N. & DALY, D.D. - Pseudoperiodic lateralized paroxysmal discharges in electroencephalogram. Neurology 21:975, 1971.

[12] 12. MILLAR, J.H.D. & COEY, A. - The EEG in necrotizing encephalitis. Electroenceph. clin. Neurophysiol. 11:582, 1959.

[13] 13. MUSGRAVE, F.S.; SANAMAN, M. & PURPURA, D.P. - Factors affecting focal discharges of epileptogenic cortex. Physiologist 5:187, 1962.

[14] 14. PURPURA, D.P.; GOLDENSOHN, E.S. & MUSGRAVE, F.S. - Synaptic and nonsynaptic processes in focal epileptogenic activity. Electroenceph. clin. Neurophysiol. 15:1051, 1963.

[15] 15. SCHWARTZ, M.S.; PRIOR, P.F. & SCOTT, D.F. - The occurrence and evolution in the EEG of a lateralized periodic phenomenon. Brain 96:613, 1973.

[16] 16. van BOGAERT, L.; RADERMECKER, J. & DEVOS, J. - Sur une observation mortelle d'encéphalite aiguë nécrotissante. Rev. neurol. (Paris) 92:329, 1955.

[17] 17. van SWEDEN, B. & HOSTE, S. - Periodic EEG discharges in phychiatry. Eur. Neurol. 22:359, 1983.