**5. Bilateral independent periodic discharges BIPDs**

BIPDs occur as LPDs involving both hemispheres, in an independent and asynchronous manner (**Figure 12**); The true prevalence and incidence of BIPDs is unknown; however, they are less common than LPDs; studies mention that seizures are also less common in association with BIPDs than with LPDs, successively 29% vs. 44% [23] and 43% vs. 70% [17]. BIPDs are associated with acute brain lesions (anoxic brain damage, stroke, CNS infection, tumor); in general the clinical status and prognosis of patients showing BIPDs is worse than those with LPDs; mortality rate for BIPDs compared to LPDs is much higher 47, 8% vs. 14% respectively [38].

#### **Figure 12.**

*Bilateral independent periodic discharges BIPDs. Black arrows show discharge arising from the left hemisphere, red arrows discharges arising from the right hemisphere.*
