Does Neurological Examination Change With Resolution of PLEDs on EEG in Non-Anoxic Patients: A Prospective Observational Study

Abstract

We present a prospective observational study of 18 consecutive non-anoxic patients with Periodic Lateralized Epileptiform Discharges (PLEDS) on their EEG, who were followed acutely till resolution of their PLEDS. We followed their electroencephalographic and clinical courses. 13 of the 18 patients were discharged from the hospital at their baseline mental status, 3 died in the hospital and 2 patients did not show any clinical improvement. All the 13 patients who improved showed complete resolution of PLEDS on their follow-up EEG. The 3 patients who died showed severe diffuse cerebral dysfunction without PLEDS on their follow-up EEGs. Of the 2 patients with no improvement, one showed severe diffuse cerebral dysfunction and the other showed persistent intermittent PLEDS which were state dependent. All patients received anti-epileptic drugs (AEDs). Structural versus non-structural PLEDs etiology made no difference in terms of the discharged patients’ outcome. Our study thus far suggests that a majority of the patients showed neurological improvement with resolution of PLEDS on their EEG. 4 of the 5 patients who did not improve showed severe diffuse cerebral dysfunction on their EEG and 1 showed intermittent PLEDS. All the patients who did poorly had initially presented with multiple convulsive generalized seizures and had multiple medical complications. We would like to see if this trend continues in a larger cohort of patients.