Salzburg Criteria, A Useful Tool in Non-Convulsive Status Epilepticus Diagnosis: A Retrospective Study

Abstract

Introduction. Non-convulsive status epilepticus (NCSE) has been traditionally a challenging electroencephalographic (EEG) diagnosis. For this reason, Salzburg consensus criteria (SCC) have been proposed to facilitate correct diagnosis. Methods. We retrospectively reanalyzed 41 cases referred to our department (from 2016 to 2018) under the suspicion of NCSE. In this study, we compared the original description (standard criteria) versus the updated description (SCC) of the same EEG. Results. Originally, 15 patients were diagnosed as NCSE (37%) and 26 patients as no NCSE (63%), using the standard criteria. Then, we analyzed EEGs according to the SCC, which led to the following results: 9 patients fulfilled the criteria for definite NCSE (22%), 20 patients were diagnosed as possible NCSE (49%) and 12 patients were diagnosed as no NCSE (29%). Subsequently, when we analyze the outcome of possible NCSE cases, we note that 50% of these patients presented mild-poor outcome (neurological deficits, deceased). Indeed, we observed worse outcomes in patients previously diagnosed as no NCSE and untreated, specifically post-anoxic cases. Conclusions. Salzburg criteria seem to be a useful tool to support NCSE diagnosis, introducing the category of possible NCSE. In our study, we observed that it contributes to improving the prognosis and management of the patients. However, more prospective studies are needed to demonstrate the accuracy of SCC.

Nonconvulsive status epilepticus characteristics in glioma patients: a retrospective study

“…Horvath et al reported that NCSE was associated with mortality during long-term follow-up (odds ratio 9.86) [29]. Additionally, Dominguez et al reported that worse outcomes were observed in patients with NCSE who had been overlooked and had not been treated properly [30]. In addition to these clinical studies, one preclinical study supports the poor outcomes of NCSE by demonstrating histological neural damage and glial reactive changes caused by NCSE using rodent models [31].…”

Die Anwendung der Salzburg-Kriterien in der Diagnose des non-konvulsiven Status epilepticus

“…Gómez Domínguez und Kollegen validierten die Salzburgkriterien im direkten Vergleich mit den zuvor verwendeten Standard-Kriterien zur NCSE-Diagnostik anhand von 41 Patienten. Eine Auswertung von Sensitivität und Spezifi tät erfolgte im Rahmen der durchgeführten Analysen nicht, allerdings erfüllten 14 der 26 initial als nicht-NCSE-verdächtig gewerteten Fälle gemäß der Salzburg-Kriterien die Diagnosekriterien eines möglichen NCSE [ 20 ] .…”

Status epilepticus: review on diagnosis, monitoring and treatment

“…The criteria 54 , 55 state that either epileptiform discharges (EDs) or rhythmic delta activity (RDA) needs to be present to diagnose NCSE during 10 s at least. Depending on the frequencies shown in EDs or RDA, two ways to proceed with the diagnosis are presented:…”