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Prognosis of Periodic and Rhythmic Patterns in Adult and Pediatric Populations

Lewis, Dalila W.; Johnson, Emily L.

Journal of Clinical Neurophysiology: July 2018 - Volume 35 - Issue 4 - p 303–308
doi: 10.1097/WNP.0000000000000442
Invited Review

Summary: Although electrographic seizures are known to have an outcome on clinical prognosis, the implications of periodic and rhythmic patterns are less clear. The outcomes of adults with these patterns have been reported and are often poor; however, the outcomes in pediatric populations are less well characterized and may be different than in the adult population, as the etiologies of periodic and rhythmic patterns may differ in children and adults. In adults, generalized periodic discharges are highly associated with toxic–metabolic disturbances, infection, and anoxic injury; 30% to 64% of patients have poor outcomes. By contrast, in pediatric patients, generalized periodic discharges are more commonly associated with refractory status epilepticus, with good outcomes in 50% to 77%. The underlying etiology of the periodic or rhythmic pattern has a large influence on overall morbidity and mortality.

Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.

Address correspondence and reprint requests to Dalila W. Lewis, MD, Department of Neurology, Johns Hopkins School of Medicine, 600 N. Wolfe St, Meyer 2-147, Baltimore, MD 21287, U.S.A.; e-mail:

The authors have no funding or conflicts of interest to disclose.

© 2018 by the American Clinical Neurophysiology Society