Abstracts

Rationale: The intent of this paper is to determine if patients with EEGs demonstrating PLEDs have a different prognostic outcome based on whether they present with clinical seizures versus no clinical seizures. Additionally, we compare our findings with those found in the literature. Methods: All EEGs obtained in our hospital from the year 2001 to 2009 were reviewed. The patient who’s EEGs met the criteria for PLEDs were selected. These were defined as repetitive focal discharge, or hemispheric complexes, consisting of spike, spike and wave or polyspike waves, recurring periodically every 1 to 2 seconds, with a return to background between discharges. The recordings were obtained on 16-channel EEGs. We divided the patients into the following two categories: PLEDs with clinical seizures or focal status epilepticus; and PLEDs with no clinical seizures. The patient’s disposition in each group was used as an indication of their prognosis. The statistical study was carried out via the chi square test. Results: The most common etiology found was ischemic stroke (20/75), followed closely by tumor (19/75) most of which were glioblastoma multiform (8/19). Other causes found were intracranial hemorrhage (15/75), herpes simplex virus encephalitis, anoxia, reperfusion syndrome status-post carotid endarterectomy, alcohol withdraw, multiple sclerosis and arterio-venous malformation. Of these patients 39 percent presented with seizures, mostly partial motor seizures. Additionally 9.2 % presented in focal status. The rest did not have any documented clinical seizure activity. The group with clinical seizures or focal status, 71.8% had a good outcome, meaning they were discharged to home or to skilled nursing home. Twenty eight percent of this group had a poor outcome. They either expired or went to hospice. Finally, in the group with no seizures, half had good and the other half had poor outcomes. No significant relationship was found between these two groups with a chi square with Fisher’s exact test value of 0.152. Conclusions: The patients who presented with PLEDs with no clinical seizure had no statically significantly different outcome compared to the group of patients with PLEDs and clinical seizures or focal status.