Clinical significance of focal periodic discharges in neonates.

Of 1,114 EEG recordings obtained for 592 neonates, focal periodic discharges were noted on 57 (5%) of recordings for 34 neonates (26 preterm and eight term). Periodic lateralized epileptiform discharges (PLEDs) were noted on four of these recordings. Sixteen patients (47%) with focal periodic discharges also had electrographic seizures on the same or a subsequent record. Stroke was the most common brain lesion (53%) in this neonatal population. Preterm neonates had discharges that were less than 60 seconds in duration and located in the parasagittal regions, while discharges in term neonates were longer in duration and were located in the temporal regions. Of the 34 neonates, 15 (44%) died, and 58% (11/19) of the survivors were abnormal with respect to neurological development. Focal periodic discharges in neonates, including PLEDs, have the same clinical significance as PLEDs recorded on EEGs in older children and adults.