PMID- 15158708
OWN - NLM
STAT- MEDLINE
DCOM- 20040802
LR  - 20151119
IS  - 1059-1311 (Print)
IS  - 1059-1311 (Linking)
VI  - 13
IP  - 5
DP  - 2004 Jul
TI  - Focal nonconvulsive status epilepticus associated to PLEDs and intense focal 
      hyperemia in an AIDS patient.
PG  - 358-61
AB  - PURPOSE: Periodic lateralised epileptiform discharges (PLEDs) can be seen 
      associated to nonconvulsive status epilepticus (NCSE), although their 
      pathophysiological meaning remains questionable. Functional neuroimaging has 
      suggested that, in this setting, PLEDs may indeed be an ictal pattern. In this 
      report we describe perfusional changes in a patient with AIDS, PLEDs and NCSE. 
      METHODS: A 37-year-old man with AIDS, cryptococcosis and recurrent epileptic 
      seizures was admitted. After initial treatment, he remained comatose, and had MRI 
      and serial EEG recordings performed. Technetium-99m-ethyl cysteinate dimer 
      (99mTc-ECD) SPECT scans were also obtained, before and after continuous 
      benzodiazepine infusion. RESULTS: EEG disclosed PLEDs over the right fronto-polar 
      region while MRI revealed meningeal thickening and scattered unspecific findings. 
      SPECT revealed marked focal hyperperfusion overlapping the areas with PLEDs, both 
      resolved after continuous midazolam infusion and clinical improvement. 
      CONCLUSIONS: This report demonstrates association of PLEDs, NCSE, and focal 
      hyperperfusion on SPECT, additionally supporting the concept of PLEDs as an ictal 
      pattern. Considering that status epilepticus may eventually not be detected by 
      conventional approaches alone, we advocate the use of functional neuroimaging to 
      assess suspected patients with impaired consciousness.
FAU - Cury, Rodrigo F
AU  - Cury RF
AD  - Section of Clinical Neurophysiology, Department of Neurology, Ribeirao Preto 
      Medical School, University of Sao Paulo, Avenida Bandeirantes 3900, 
      CEP:14.048-900, Monte Alegre, Ribeirao Preto, Sao Paulo, Brazil.
FAU - Wichert-Ana, Lauro
AU  - Wichert-Ana L
FAU - Sakamoto, Americo C
AU  - Sakamoto AC
FAU - Fernandes, Regina M F
AU  - Fernandes RM
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - Seizure
JT  - Seizure
JID - 9306979
RN  - 0 (Radiopharmaceuticals)
RN  - 3B744AG22N (Technetium Tc 99m Exametazime)
SB  - IM
MH  - Acquired Immunodeficiency Syndrome/*complications
MH  - Adult
MH  - *Electroencephalography
MH  - Functional Laterality/physiology
MH  - Humans
MH  - Hyperemia/*etiology
MH  - Male
MH  - *Periodicity
MH  - Radiopharmaceuticals
MH  - Status Epilepticus/*physiopathology
MH  - Technetium Tc 99m Exametazime
MH  - Tomography, Emission-Computed, Single-Photon
EDAT- 2004/05/26 05:00
MHDA- 2004/08/03 05:00
CRDT- 2004/05/26 05:00
PHST- 2004/05/26 05:00 [pubmed]
PHST- 2004/08/03 05:00 [medline]
PHST- 2004/05/26 05:00 [entrez]
AID - S1059131103001973 [pii]
AID - 10.1016/j.seizure.2003.07.001 [doi]
PST - ppublish
SO  - Seizure. 2004 Jul;13(5):358-61. doi: 10.1016/j.seizure.2003.07.001.