LPD (lateralized periodic discharges)

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Synonyme: PLED (Periodic lateralized epileptiform discharges)

  • Lateralized: Unilateral
  • Periodic: Relative constant interval between the discharges, which varies between 0.5 and 3 seconds (most often around 1 second)
  • Discharge: Could be Delta waves or sharp waves with a “epileptiform” morphology
  • If a more ictal appearance it can be categorized as LPD+:[1]
    • +F: superimposed fast activity.
    • +R: superimposed rhythmic or quasi-rhythmic activity.
    • +FR: superimposed fast activity and rhythmic or quasi-rhythmic activity.
  • LPD’s are seen in acute cerebral laesion
    • Non specific:
      • Acute cerebrovascular events
      • Encephalitis
      • Subdural hematoma
      • Other structural lesions
  • Tend to disappear in weeks
  • Higher risk of seizures (50-80%) in patients with LPD’s [2]



LPD's left parieto occipital in a male of 78 years old with a hemmorrhage left occipital (average) LPD's left parieto occipital male 78 yo with a hemmorrhage left occipital (average).png


Notes

  1. ACNS STANDARDIZED ICU EEG NOMENCLATURE v. 2012
  2. Garcia-Morales et al, Periodic lateralized epileptiform discharges: etiology, clinical aspects, seizures, and evolution in 130 patients.J Clin Neurophysiol. 2002 Apr;19(2):172-7.