Electrographic significance of Periodic Discharges and association with etiology and outcome in tertiary care hospital, a retrospective cohort study

Abstract Background: Periodic discharges in electroencephalograms (EEGs) represent rhythmic wave patterns and can indicate acute or subacute brain damage. Although they may predispose patients to seizures, not all are epileptiforms. This study focused on electrographical periodic discharges and aimed to elucidate their frequency, etiological associations, and clinical outcomes within a tertiary care hospital setting. Results: This retrospective observational cohort study spanned two years, from January 2021 to January 2023. It included patients aged 18 years and above with EEG-confirmed periodic discharges. Data, including demographics, symptoms, EEG findings, neuroimaging results, treatment, and outcomes, were collected and analyzed using SPSS version 22. Of the 41 patients analyzed, 51.2% were female, with an average age of approximately 58.5 years. Generalized tonic-clonic seizures were the most common clinical presentation (48.8%), with ischemic stroke as the leading etiological factor (31.7%). Lateralized periodic discharges (LPDs) were the most common EEG finding. Notably, 34% of patients exhibited chronic imaging changes, primarily encephalomalacia and gliosis. The majority (87.8%) were discharged home, with a minority (12.2%) experiencing mortality, often associated with status epilepticus or metabolic encephalopathy. Conclusion: This study highlights the importance of recognizing periodic discharges in EEGs within the context of a tertiary care hospital. The findings of this study emphasize the potential gravity of periodic discharges, as indicated by mortality rates and functional outcomes. An improved understanding of these periodic discharges and their associated conditions can guide clinical decision-making and enhance patient care within tertiary care hospital settings.