Abstract:
Periodic lateralized epileptiform discharges (PLEDs) or lateralized periodic discharges (LPDs) are a well-known variant of pathological EEG activity. However, the mechanisms underpinning the appearance of this pattern are not completely understood. The heterogeneity of the features derived from LPDs patterns, and the wide range of pathological conditions in which they occur, raise a question about the unifying mechanisms underlying these phenomena. This paper reassesses the current opinion surrounding LPDs which considers glutamate excitotoxicity to be the primary pathophysiological basis, and the penumbral region to be the main morphological substrate. Arguments in favour of this hypothesis are presented, with interpretations supported by evidence from recent literature involving clinical and experimental data. Presently, no single hypothesis places considerable emphasis on the pathochemical properties of LPDs, which are implicitly meaningful towards better understanding of the clinical significance of this pattern.
摘要:
周期性侧向癫痫样放电(PLED)或侧向周期性放电(LPD)是病理性EEG活动的众所周知的变体。然而,支撑这种模式出现的机制还没有完全理解。从LPDs模式导出的特征的异质性,以及它们发生的各种病理状况,提出一个关于这些现象背后的统一机制的问题。本文重新评估了围绕LPD的当前观点,该观点认为谷氨酸兴奋性毒性是主要的病理生理基础,半影区是主要的形态学底物。提出了支持这一假设的论点,最新文献中涉及临床和实验数据的证据支持解释。目前,没有一个单一的假设非常重视LPDs的病理化学性质,这对于更好地理解这种模式的临床意义是隐含意义的。