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Epileptic Disorders

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Prolonged ictal monoparesis with parietal Periodic Lateralised Epileptiform Discharges (PLEDs) Volume 15, numéro 2, June 2013

Auteurs
Department of Neurology, Graduate School of Medicine, Kyoto University, Sakyoku, Department of Neurology, Utano National Hospital, National Hospital Organization, Ukyoku, Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Sakyoku, Kyoto, Japan

We report a patient with prolonged monoparesis and parietal periodic lateralised epileptiform discharges (PLEDs). The patient was a 73-year-old man with chronic myelomonocytic leukaemia who developed persisting monoparesis of the right arm, sensory aphasia, and finger agnosia, initially associated with focal clonic seizures. These neurological deficits remained for seven days without subsequent focal clonic seizures. The EEG showed left-sided PLEDs, maximal in the left occipito-parietal area. Ten days later, following phenytoin treatment, these symptoms suddenly improved and parietal PLEDs disappeared. Sustained PLEDs in the left parietal region may have been causally associated with ictal paresis in this patient.