%0 Journal Article
%T Periodic lateralized epileptiform discharges as manifestation of pneumococcal meningoencephalitis
%A Francisco Hern¨˘ndez-Fern¨˘ndez
%A Eva Fern¨˘ndez-D¨Şaz
%A Jose M Pardal-Fern¨˘ndez
%A Tom¨˘s Segura
%A Jorge Garc¨Şa-Garc¨Şa
%J International Archives of Medicine
%D 2011
%I BioMed Central
%R 10.1186/1755-7682-4-23
%X We report on a 75-year old woman with pneumococcal meningoencephalitis who presented altered level of consciousness, acute focal deficits, convulsive seizures and PLEDs in left hemisphere. The finding of PLEDs on the electroencephalogram is related to focal lesions of heterogeneous origin, which up to date, have not been documented in pneumococcal infections of the central nervous system. Our case highlights the importance of identifying and addressing any modifiable etiologic factors of PLEDs.Electroencephalogram (EEG) in acute meningoencephalitis is always abnormal. In most cases of nervous central system infectious (CNS) diseases a diffuse slowing is visible with bilateral paroxystic and synchrone affectation [1]. One of the most frequent paroxystic complexes is the pattern of periodic lateralized epileptic form discharges (PLEDs). This is defined by presence of a pattern of repetitive paroxysmal slow or sharp waves, uni or bilateral at intervals of between 0.5 to 3 seconds [2,3]. The morphology of PLED is epileptiform. However, due to some of their characteristics they are considered as interictal pattern. In any case, it is usually associated with epileptic seizures [4], even status epilepticus, which must be excluded and treated appropriately.There is a wide variety of potential PLEDs etiologies, most of them focal lesions, of which acute ischemic stroke is the most frequent cause in all series. Although PLEDs may also appear in tumours, haemorrhages or CNS infections, this waveform is considered a quite specific EEG pattern for herpes simplex virus encephalitis [5], but they are also related to inflammatory processes of different origins such as neurosyphillis [6], demyelinizing diseases [7], neurocysticercosis [8], influenza [9], neuro-Behcet's disease [10] or bacterial meningoencephalitis, including Q fever [11].We present a patient with pneumococcal meningoencephalitis associated with PLEDs on the EEG in the symptomatic hemisphere. This case exemplifies th
%U http://www.intarchmed.com/content/4/1/23