Estado epiléptico no convulsivo en el siglo XXI: clínica, diagnóstico, tratamiento y pronóstico

Gómez‐Ibáñez, Asier; Urrestarazu, Elena; Viteri, C.

doi:10.33588/rn.5402.2011250

Cited by 4 publications

(2 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 In developed countries, the most common etiologies include stroke, seizures/epilepsy, metabolic disturbances, intracerebral neoplasm, and hypoxic-anoxic injury. 36 In developing countries, similar etiologies have been reported. 22 In our study, the main etiology was cryptogenic (56%), followed by neuroinfections (22.4%), and cerebrovascular disease ranked fourth among the etiologies (6.7%).…”

Section: Discussionmentioning

confidence: 60%

Nonconvulsive Status Epilepticus: Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico

San-Juan

Ángeles

González-Aragón

et al. 2022

Journal of Clinical Neurophysiology

View full text Add to dashboard Cite

There is a lack of clinical and epidemiological knowledge about nonconvulsive status epilepticus (NCSE) in developing countries including Mexico, which has the highest prevalence of epilepsy in the Americas. Our aim was to describe the clinical findings, EEG features, and outcomes of NCSE in a tertiary center in Mexico.Methods: We conducted a retrospective case series study (2010-2020) including patients ( $ 15 years old) with NCSE according to the modified Salzburg NCSE criteria 2015 with at least 6 months of follow-up. We extracted the clinical data (age, sex, history of epilepsy, antiseizure medications, clinical manifestations, triggers, and etiology), EEG patterns of NCSE, and outcome. Descriptive statistics and multinomial logistic regression were used.Results: One hundred thirty-four patients were analyzed; 74 (54.8%) women, the total mean age was 39.5 (15-85) years, and 71% had a history of epilepsy. Altered state of consciousness was found in 82% (including 27.7% in coma). A generalized NCSE pattern was the most common (32.1%). The NCSE etiology was mainly idiopathic (56%), and previous uncontrolled epilepsy was the trigger in 48% of patients. The clinical outcome was remission with clinical improvement in 54.5%. Multinomial logistic regression showed that the patient's age (P ¼ 0.04), absence of comorbidities (P ¼ 0.04), history of perinatal hypoxia (P ¼ 0.04), absence of clinical manifestations (P ¼ 0.01), and coma (P ¼ 0.03) were negatively correlated with the outcome and only the absence of generalized slowing in the EEG (P ¼ 0.001) had a significant positive effect on the prognosis.Conclusions: Age, history of perinatal hypoxia, coma, and focal ictal EEG pattern influence negatively the prognosis of NCSE.

show abstract

Section: Discussionmentioning

confidence: 60%

Nonconvulsive Status Epilepticus: Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico

San-Juan

Ángeles

González-Aragón

et al. 2022

Journal of Clinical Neurophysiology

View full text Add to dashboard Cite

show abstract

“…The neuronal network generating these seizures includes the thalamic and neocortical populations [13]. NCSE is difficult to diagnose because it presents in protean ways and lacks overt convulsive activity [14]. The definitive diagnosis is made with an EEG.…”

Section: Introductionmentioning

confidence: 99%

Non Convulsive Status Epilepticus: An Elusive Diagnosis

Millán‐Guerrero

Isaís-Millán

2016

OJEpi

View full text Add to dashboard Cite

Absence status is the most common form of non-convulsive status epilepticus and is characterized by confusion with varying degrees of memory loss and cognitive impairment. Patients and Method: Three children were sent to neurological consultation due to behavioral alterations and a prolonged confused state; they were hospitalized and treated with sodium diphenylhydantoinate (DPH) IV at a dose of 10 mg/Kg. Results: The duration of symptoms varied from 6 months to 10 days. All three patients presented with global mental alterations, showing slowness in response and action. The electroencephalogram showed a pattern of slow, generalized stem and poly-stemwavelengths of 3 -4 Hz, which were registered for one hour. After the DPH bolus, the attack spontaneously ended in the 3 patients and upon examination all three presented with amnesia of the events occurring during the attack. In the follow-up, two of the patients did not experience further episodes and they showed normal scholastic achievement. The third patient however, after suffering a 6-month status epilepticus, failed the school year and finished his elementary education until the age of 15, experiencing similar difficulties with his secondary education. Discussion: Nonconvulsive status epilepticus is more difficult to diagnose mainly because the manifestations are predominantly psychiatric and can be confused with other diseases or with an overdose of anticonvulsive drugs. A prolonged state of mental confusion, with no other explanation, should alert the attending physician to take an electroencephalogram in order to confirm the diagnosis. In our patients, DPH immediately controlled paroxysmal activity. We can therefore conclude that the problem is not in the treatment, but rather in making the correct diagnosis.

show abstract