Neuroradiological findings in a case of periodic lateralized epileptiform discharges (PLEDs) associated with meningeal carcinomatosis

Neuroradiological findings in a case of periodic lateralized epileptiform discharges (PLEDs) associated with meningeal carcinomatosis were reported. A 53-year-old male developed disturbance of consciousness followed by headache and vomiting. Although CT scan failed to reveal any abnormality, EEG demonstrated PLEDs, predominatly on the right parieto-occipital region. T2 weighted MR image (T2WI) showed a hyperintensity area in the right parieto-frontal lobes where were depicted as hyperperfused area on ECD-SPECT. On angiogram, an early venous filling of cortical vein on the right parietal lobe was also demonstrated. Five months after the onset, when PLEDs were not noted, both hyperintensity lesion on T2WI and early venous filling on angiogram were disappeared. The right parito-frontal lobes depicted as hypoperfused area on the repeated SPECT. These findings support the current concept that PLEDs represent focal status epileptics.