PLEDS are most likely to be seen in a patient presenting with what condition?

PLEDS, or periodic lateralized epileptiform discharges, are abnormal EEG patterns observed in specific clinical conditions. These discharges are most commonly associated with metabolic disturbances, with hypoglycemia being one of the conditions where they may be prevalent.

When a patient experiences hypoglycemia, the brain does not receive adequate glucose, which is its primary energy source. This deficiency can lead to neuronal dysfunction and excitability, resulting in abnormal electrical activity manifesting as PLEDS on an electroencephalogram (EEG). Hence, in the context of this question, recognizing that PLEDS are representative of underlying metabolic or structural abnormalities, particularly in relation to glucose availability, is key to understanding their association with hypoglycemia.

In contrast, while conditions like liver failure, cerebral embolus, and acute drug toxicity can lead to various EEG changes, they are less specifically associated with the appearance of PLEDS. Liver failure might show other alterations related to hepatic encephalopathy, cerebral embolus may present with less localized findings unless there's significant focal cortical irritation, and acute drug toxicity can elicit a wide array of EEG patterns that do not routinely include PLEDS as a signature finding. Thus, hypoglycemia stands out as the condition most likely