• Periodic lateralized epileptiform discharges (PLEDs) occurred in three patients during alcohol withdrawal, in two patients with episodes of anoxic ischemia, and in one patient under both conditions. In contrast to previous observations that PLEDs are often associated with acute gross destructive lesions, autopsy results and neurological studies reported here indicated that alcohol withdrawal and/or anoxic ischemia may activate preexisting focal hemispheric lesions to produce PLEDs.