CLINICAL-SIGNIFICANCE OF PERIODIC LATERALIZED EPILEPTIFORM DISCHARGESIN CHILDREN WITH RELATION TO LEVEL OF CONSCIOUSNESS

Six children with acute cerebral insult, ranging in age from 3 days to 8 years, revealed periodic lateralized epileptiform discharges in the ir electroencephalographic recordings. Their etiologic factors were ce rebral infarction, intracranial bleeding, purulent meningitis, acute i nfantile hemiplegia, and encephalitis. Each patient exhibited a differ ent type of convulsive seizure. Computer tomography or magnetic resona nce imaging revealed diffuse lesions covering the cerebral cortex and subcortical white matter in 2 patients, a lesion of the subcortical wh ite matter in 1 patient, a linear lesion in the cortex and along the b orderline between the cortex and the subcortical white matter in 1 pat ient, and localized lesions in the cortex and basal ganglia in 1 patie nt. There were findings indicating the disconnection of the cerebral c ortex with deeper structures in 3 patients. The appearance rate of per iodic lateralized epileptiform discharges increased at levels of consc iousness from 5 to 7 on a pediatric modification of the Glasgow Coma S cale. At levels of consciousness from 8 to 14 and below 4, the rate wa s very low.