Behavioral Manifestations of Nonconvulsive Status Epilepticus

Kaplan, Peter W.

doi:10.1006/ebeh.2002.0336

Cited by 80 publications

(36 citation statements)

References 56 publications

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“…16,17,26,39,40 Also, staring and mutism can be seen with benzodiazepine withdrawal encephalopathy, lithium toxicity, and psychogenic states. Increased tone with diminished consciousness can occur with serotonin syndrome, neuroleptic malignant syndrome, and tiagabine encephalopathy.…”

Section: Differential Diagnosis Of Nonconvulsive Status Epilepticusmentioning

confidence: 99%

“…The different types of frontal lobe status have gained recognition with the work of Thomas et al 25 A classification of NCSE is given in Table 1. 26 NCSE can be classified by age of presentation. The clinical expression is pleomorphic 16,[27][28][29][30][31][32][33][34][35][36][37][38][39][40] and may vary according to age, partially because of the maturation of the central nervous system.…”

Section: Classificationmentioning

confidence: 99%

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The Clinical Features, Diagnosis, and Prognosis of Nonconvulsive Status Epilepticus

Kaplan

2005

The Neurologist

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Nonconvulsive status epilepticus (NCSE) is a state of ongoing seizure activity for at least 30 minutes, with cognitive or behavioral changes, but without convulsive clinical manifestations. It requires EEG for confirmation. It has been categorized into groups having focal or generalized EEG epileptic activity; and by etiology and level of consciousness (which predict outcome). Points of contention include the evolving definition of what constitutes NCSE, various reasons for a delayed, missed, or misidentified diagnosis, and the optimal management of these conditions.

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Section: Differential Diagnosis Of Nonconvulsive Status Epilepticusmentioning

confidence: 99%

Section: Classificationmentioning

confidence: 99%

The Clinical Features, Diagnosis, and Prognosis of Nonconvulsive Status Epilepticus

Kaplan

2005

The Neurologist

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“…It is worse when periodic patterns are included as an ictal one 15 . NCSE may be regarded as proven, if both the EEG and the clinical state are solved with antiepileptic drugs 16 . The reverse does not exclude an epileptic condition; otherwise, all refractory SE would have to be considered as nonepileptic, which is biologically not plausible 17 .…”

Section: Discussionmentioning

confidence: 99%

Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

Liberalesso

Garzón

Yacubian

et al. 2012

Arq. Neuro-Psiquiatr.

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OBJECTIVE: Nonconvulsive status epilepticus (NCSE) is currently considered as one of the most frequent types of status epilepticus (SE). The objective of the present study was to identify the natural history of the electrographical evolution of refractory NCSE and to establish the relationship between ictal patterns and prognosis. METHODS: We analyzed, retrospectively, 14 patients with loss of consciousness and NCSE. The ictal patterns were classified as discrete seizures (DS), merging seizures (MS), continuous ictal discharges (CID), continuous ictal discharges with flat periods (CID-F), and periodic lateralized epileptiform discharges (PLEDs). RESULTS: The ictal patterns were DS (n=7; 50.0%), PLEDs (n=3; 1.4%), CID (n=2; 14.3%), MS (n=1; 7.1%), and CID-F (n=1; 7.1%). CONCLUSIONS: NCSE electrographic findings are heterogeneous and do not follow a stereotyped sequence. PLEDs were related to a higher probability of neurological morbidity and mortality.

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“…Patients with NCSzs are not exclusively in the neurology ICUs; studies on comatose patients from any ICU 12 , pediatric ICU 18 , or patient having unexplained altered mental status anywhere in the hospital have identified ongoing NCSz in 8%-37%, suggesting that at-risk patients can be found in any critical care setting 8,21,22,23,24,25,26 . It is important to note that many of the studies are retrospective and included some patient for whom there was a high suspicion for NCSz based on previous history of seizures, rhythmic movements or a possibly epileptogenic injury potentially contributing to the high rate of NCSz observed in some studies.…”

Section: Detection Of Non-convulsive Seizures (Ncsz) and Non-convulsimentioning

confidence: 99%

EEG in ICU: A monitoring tool for critically ill patient

Banu

2014

Bangladesh Crit Care J

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Electroencephalographic monitoring provides dynamic information about the brain function that permits early detection of changes in neurologic status, which is especially useful when the clinical examination is limited. Identification of ongoing electrographic seizures, non-convulsive status epilepticus (NCSE), periodic epileptogenic discharges (PED), irreversible cerebral dysfunction i.e., isoelectric tracing would help the care providers in appropriate decision making regarding the management. Non-convulsive seizures (NCSz) are more common than previously recognized and are associated with worse outcome if not treated in time. Majority of seizures at the ICU are not clinically identified because of the disease phenomena or as the patient may remain under sedation. Studies revealed the first NCSz within 1 to 24 hours of EEG monitoring; longer period of monitoring is required in comatose patient and those with PED. Factors associated with an increased risk of NCSz and NCSE include coma, prior clinical seizures, CNS infection, trauma, stroke, hypoxic ischemic encephalopathy, brain tumor, recent neurosurgery, and PED.In resource-poor situation, EEG is frequently requested to confirm brain death, particularly where there is limited information on neurological examination or inconclusive apnea test; or when the patient is in prolonged state of coma. Presence of isoelectric tracing for at least 30 minutes in the EEG along with other clinical evidences is helpful in such situations. Extreme care should be taken for recording and reviewing continuous EEG (cEEG) monitoring at the ICU where sources of electrical noise are present. Patients identified with electrographic seizures and mild to moderate degree encephalopathy, with presence of normal background activities had better outcome compared to those with PED, monorrhythmic alpha beta coma and severe generalized encephalopathy. Real-time detection of ischemia at a reversible state is technologically feasible with cEEG and should be developed into a practical form for prevention of in-hospital infarction. Brain function monitoring with EEG is useful and this is in great demand at the ICU of present time. Such monitoring can help to improve neurological outcome in a variety of ICU settings. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19954 Bangladesh Crit Care J March 2014; 2 (1): 28-34

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Behavioral Manifestations of Nonconvulsive Status Epilepticus

Cited by 80 publications

References 56 publications

The Clinical Features, Diagnosis, and Prognosis of Nonconvulsive Status Epilepticus

The Clinical Features, Diagnosis, and Prognosis of Nonconvulsive Status Epilepticus

Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

EEG in ICU: A monitoring tool for critically ill patient

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