Chronic PLEDs with transitional rhythmic discharges (PLEDs-plus) in remote stroke

Background. Periodic lateralized epileptiform discharges (PLEDs) are a rare phenomenon in electroencephalography, occurring in acute structural brain lesions. In general, PLEDs appear transiently in acute lesions, but a few reports have described persistent PLEDs in chronic lesions. Case report. An 86-year-old female was admitted, in 1999, with a left MCA stroke associated with right hand focal motor seizures. The first EEG in February of 2002 showed PLEDs over the left hemisphere associated with rhythmic discharges (PLEDs-plus). The patient was admitted on a second occasion in 2003 because of three sequential seizures and the EEG showed a similar pattern. Finally in 2006, the patient was admitted again because of sequential complex partial seizures and an EEG showed the same PLEDS-plus pattern as the EEGs of 2002 and 2003. Discussion. We report an unusual case of chronic PLEDs associated with rhythmic discharges in a patient with recurrent seizures and remote stroke.