Periodic lateralized epileptiform discharges are most commonly found in the EEGs of patients with which condition?

Periodic lateralized epileptiform discharges (PLEDs) are typically associated with significant structural brain lesions, and they are most commonly observed in the setting of acute cerebral infarction. This phenomenon reflects the presence of focal cortical irritability that arises due to the underlying pathophysiological changes following a stroke. In the context of acute cerebral infarction, brain tissue is damaged and the surrounding areas may develop abnormal electrical discharges, leading to the characteristic waveform seen as PLEDs on an EEG.

While the other conditions listed can also show various EEG abnormalities, they are less specifically linked to PLEDs. For instance, brain stem tumors may result in different types of EEG changes based on their effects on the brainstem and associated pathways. Multiple sclerosis can lead to diffuse slowing and other non-specific changes rather than the lateralized discharges characteristic of PLEDs. Cephalgia, or headaches, are generally not associated with specific EEG changes, especially not with periodic lateralized epileptiform discharges. Therefore, acute cerebral infarction stands out as the primary condition wherein PLEDs are commonly identified in the EEG findings.