Descargas epileptiformes periódicas lateralizadas: II. Aspectos evolutivos

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

doi:10.1590/S0004-282X1988000100004

Resumos

Foi feita a investigação da evolução das PLEDs em 9 pacientes, com idade variando entre 7 meses e 73 anos. As PLEDs evoluiram uniformemente para o desaparecimento, em um período curto, menor que 4 dias em 5 casos. Em 4 casos a evolução foi para atividade de base lenta, com posterior normalização em dois. Três casos evoluíram para período de supressão e para o óbito. Dois para atividade irritativa localizada, a qual já havia sido registrada anteriormente em um deles. Estes dados sugerem que as PLEDs dependem de um ponto crítico na alteração da atividade neuronal para seu aparecimento e manutenção. Não foi observada correlação entre a evolução das PLEDs, sempre para o desaparecimento, e evolução clínica, que foi variável.

A investigation was done on EEG evolution of 9 patients with PLEDs. In all patients PLEDs eventualy disappeared, in general in a short period, less than 4 daysin 5 cases. In 4 cases evolution was to slow background activity, and to posterior normalization in 2. In 3 cases evolution was to delta activity and suppression bursts, and all the 3 patients died. In the last 2 patients PLEDs were replaced by localized paroxysmal activity, which was anteriorly registered in 1. PLEDs was found in acute dysfunction of CNS, and in epileptic patients in periods of increased seizure activity. These data suggest that a critical point of alteration of the normal neuronal activity is needed for appearance and maintenance of PLEDs. No correlation could be done between the evolution of PLEDs, always to disappearance, and clinical outcome, that was variable.

Ademir Baptista da Silva; Paulo H. F. Bertolucci

Professor Adjunto-Doutor - Setor de Eletrencefalografia, Disciplina de Neurologia, Escola Paulista de Medicina

RESUMO

Foi feita a investigação da evolução das PLEDs em 9 pacientes, com idade variando entre 7 meses e 73 anos. As PLEDs evoluiram uniformemente para o desaparecimento, em um período curto, menor que 4 dias em 5 casos. Em 4 casos a evolução foi para atividade de base lenta, com posterior normalização em dois. Três casos evoluíram para período de supressão e para o óbito. Dois para atividade irritativa localizada, a qual já havia sido registrada anteriormente em um deles. Estes dados sugerem que as PLEDs dependem de um ponto crítico na alteração da atividade neuronal para seu aparecimento e manutenção. Não foi observada correlação entre a evolução das PLEDs, sempre para o desaparecimento, e evolução clínica, que foi variável.

SUMMARY

A investigation was done on EEG evolution of 9 patients with PLEDs. In all patients PLEDs eventualy disappeared, in general in a short period, less than 4 daysin 5 cases. In 4 cases evolution was to slow background activity, and to posterior normalization in 2. In 3 cases evolution was to delta activity and suppression bursts, and all the 3 patients died. In the last 2 patients PLEDs were replaced by localized paroxysmal activity, which was anteriorly registered in 1. PLEDs was found in acute dysfunction of CNS, and in epileptic patients in periods of increased seizure activity. These data suggest that a critical point of alteration of the normal neuronal activity is needed for appearance and maintenance of PLEDs. No correlation could be done between the evolution of PLEDs, always to disappearance, and clinical outcome, that was variable.

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Trabalho realizado no Setor de Eletrencefalografia, Disciplina de Neurologia, Escola Paulista de Medicina

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. Bertolucci PHF, Silva AB - Descargas epileptiformes periódicas lateralizadas: I. Aspectos clínicos e eletrencefalográficos. Arq Neuro-Psiquiat (São Paulo) 45: 364, 1987.
3. Chatrian GE - An EEG pattern: pseudo-rhythmic recurrent sharp waves. Its relationship to local cerebral anoxia and hypoxia. Electroenceph Clin Neurophysiol 13: 144, 1961.
4. Chatrian GE, 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.
5. Echlin FA, Arnett V, Zoli J - Paroxysmal high voltage discharges from isolated and partially isolated human and animal cortex. Electroenceph Clin Neurophysiol 4 :147, 1952.
6. Echlin FA - The supersensitivity of chronically «isolated» cerebral cortex as a mechanism in focal epilepsy. Electroenceph Clin Neurophysiol 11:697, 1959.
7. Gaches J - Activités périodiques en EEG. Rev Electroencéphalogr Neurophysiol Clin 1: 9, 1971.
8. Gloor P, Kalabay O, Giard N - The electroencephalogram in diffuse encephalopathies: electroencephalographic correlates of gray and white matter lesions. Brain 91: 779, 1968.
9. Halliday AM - The electrophysiological study of myoclonus in man. Brain 90:241, 1967.
10. Hughes JR, Schlagenhauff RE - The periodically recurring focal discharge. Epilepsia 6:156, 1965.
11. Lebeau J, Dondey M - Importance diagnostique de certaines activités électroencéphalographiques latéralisées, périodiques ou à tendance périodique au cours des abcés du cerveau. Electroenceph Clin Neurophysiol 11:43, 1959.
12. Meyer JS, Portnoy HD - Post-epileptic paralysis: a clinical and experimental study. Brain 82: 162, 1959.
13. Naquet R, France G, Vigouroux R - Données nouvelles sur certaines décharges paroxystiques du carrefour pariéto-temporo-occipital rencontrées chez l'homme. Zentralbl Neurochir 4: 153, 1965.
14. Purpura DP, Goldensohn ES, Musgrave FS - Synaptic and nonsynaptic processes in focal epileptogenic activity. Electroenceph Clin Neurophysiol 15: 1051, 1963.
15. Schwartz MS, Prior PF, Scott DF - The occurrence and evolution in the EEG of a lateralized periodic phenomenon. Brain 96:613, 1973.
16. Terzano MG, Parrino L, Mazzucchi A, Moretti G - Confusional states with periodic lateralized epileptiform discharges (PLEDs): a peculiar epileptic syndrome in the elderly. Epilepsia 27: 446, 1986.
17. van Sweden B, Hoste S - Periodic EEG discharges in psychiatry. Eur Neurol 22: 359, 1983.

Descargas epileptiformes periódicas lateralizadas: II. Aspectos evolutivos

Periodic lateralized epileptiform discharges: II. Evolutive patterns

Datas de Publicação

Publicação nesta coleção
22 Jun 2011
Data do Fascículo
Mar 1988

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. Bertolucci PHF, Silva AB - Descargas epileptiformes periódicas lateralizadas: I. Aspectos clínicos e eletrencefalográficos. Arq Neuro-Psiquiat (São Paulo) 45: 364, 1987.

[3] 3. Chatrian GE - An EEG pattern: pseudo-rhythmic recurrent sharp waves. Its relationship to local cerebral anoxia and hypoxia. Electroenceph Clin Neurophysiol 13: 144, 1961.

[4] 4. Chatrian GE, 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.

[5] 5. Echlin FA, Arnett V, Zoli J - Paroxysmal high voltage discharges from isolated and partially isolated human and animal cortex. Electroenceph Clin Neurophysiol 4 :147, 1952.

[6] 6. Echlin FA - The supersensitivity of chronically «isolated» cerebral cortex as a mechanism in focal epilepsy. Electroenceph Clin Neurophysiol 11:697, 1959.

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

[8] 8. Gloor P, Kalabay O, Giard N - The electroencephalogram in diffuse encephalopathies: electroencephalographic correlates of gray and white matter lesions. Brain 91: 779, 1968.

[9] 9. Halliday AM - The electrophysiological study of myoclonus in man. Brain 90:241, 1967.

[10] 10. Hughes JR, Schlagenhauff RE - The periodically recurring focal discharge. Epilepsia 6:156, 1965.

[11] 11. Lebeau J, Dondey M - Importance diagnostique de certaines activités électroencéphalographiques latéralisées, périodiques ou à tendance périodique au cours des abcés du cerveau. Electroenceph Clin Neurophysiol 11:43, 1959.

[12] 12. Meyer JS, Portnoy HD - Post-epileptic paralysis: a clinical and experimental study. Brain 82: 162, 1959.

[13] 13. Naquet R, France G, Vigouroux R - Données nouvelles sur certaines décharges paroxystiques du carrefour pariéto-temporo-occipital rencontrées chez l'homme. Zentralbl Neurochir 4: 153, 1965.

[14] 14. Purpura DP, Goldensohn ES, Musgrave FS - Synaptic and nonsynaptic processes in focal epileptogenic activity. Electroenceph Clin Neurophysiol 15: 1051, 1963.

[15] 15. Schwartz MS, Prior PF, Scott DF - The occurrence and evolution in the EEG of a lateralized periodic phenomenon. Brain 96:613, 1973.

[16] 16. Terzano MG, Parrino L, Mazzucchi A, Moretti G - Confusional states with periodic lateralized epileptiform discharges (PLEDs): a peculiar epileptic syndrome in the elderly. Epilepsia 27: 446, 1986.

[17] 17. van Sweden B, Hoste S - Periodic EEG discharges in psychiatry. Eur Neurol 22: 359, 1983.