Simple partial status epilepticus: causes, treatment, and outcome in 47 patients.

Scholtes, F.B.J.; Renier, W.O.; Meinardi, H.

doi:10.1136/jnnp.61.1.90

Cited by 27 publications

(20 citation statements)

References 9 publications

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“…There are many patients with focal. SE recognized clinically and treated without EEGs, and some patients with focal SE do not have clear seizures on the EEG (5,8). That EEGs were obtained in our patients suggests that the diagnosis was more difficult and that patients were more complicated and sicker than the average patient with focal SE.…”

Section: Discussionmentioning

confidence: 61%

“…Nonconvulsive SE and status limited to focal seizures are much less common (3)(4)(5). Except for series of patients with epilepsia partialis continua (EPC) (6,7) or simple partial seizures (5), most reports of focal SE are restricted to isolated cases or small series. A broad spectrum of focal SE has been described, including prolonged sensory seizures (S), ictal catatonia (9) or atonia (lo), anarthric SE due to opercular seizures ( I I ) , and more classic aphasias (12)(13)(14).…”

mentioning

confidence: 99%

“…Frequent recurrent dis-crete electrographic seizures support a diagnosis of focal SE (5,19), but continuous epileptiform discharges are also a frequent finding (19), and patients may alternate between these patterns (20). Continuous discharges are sometimes considered simply the sign of a damaged cortex rather than a treatable epileptic condition.…”

mentioning

confidence: 99%

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Focal Status Epilepticus: Clinical Features and Significance of Different EEG Patterns

1999

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Summary:Purpose: Focal status epilepticus is typically diagnosed by the observation of continuous jerking motor activity, but many other manifestations have been described. EEG evidence of focal status may take several forms, and their interpretation is controversial. We detailed the clinical spectrum of focal status in patients diagnosed by both clinical deficit and EEG criteria and contrasted clinical manifestations in patients with different EEG patterns.Methods: Patients were diagnosed with a neurologic deficit and discrete recurrent focal electrographic seizures or rapid, continuous focal epileptiform discharges on EEG. Clinical findings were determined by chart review.Results: Of 41 patients with focal status, acute vascular disease was the cause in 21; 10 of 41 had exacerbations of prior epilepsy. A variety of clinical seizure types occurred, both before and after the EEG diagnosis, but the diagnosis was not expected in 28 patients before the EEG. Three had no obvious clinical seizures. Focal motor seizures and an abnormal mental status were the most common manifestations at the time of the EEG. With antiepileptic drugs, almost all had control of clinical seizures, and most improved in mental status. Patients with rapid continuous focal epileptiform discharges were nearly identical in presentation, likelihood of diagnosis, subsequent seizures, response to medication, and outcome to those with discrete seizures on EEG.Conclusions: Focal status epilepticus may be seen with a wide variety of clinical seizure types or without obvious clinical seizures. The diagnosis is often delayed or missed and should be considered after strokes or clinical seizures when patients do not stabilize or improve as expected. The diagnosis should be made equally whether patients have discrete electrographic seizures or continuous rapid focal epileptiform discharges on the EEG, and the same response to medications and outcome should be anticipated for the two groups.

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Section: Discussionmentioning

confidence: 61%

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confidence: 99%

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Focal Status Epilepticus: Clinical Features and Significance of Different EEG Patterns

1999

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“…The vast majority of patients with simple partial SE (SPSE) presents with somatomotor features [Scholtes et al 1996b] and are not covered in this review. By definition, the clinical changes in nonconvulsive SPSE do not include an altered contact with the environment, and 'consciousness is preserved' as opposed to complex partial SE (CPSE).…”

Section: Simple Partial Sementioning

confidence: 99%

Nonconvulsive status epilepticus: a diagnostic and therapeutic challenge in the intensive care setting

Holtkamp

Meierkord

2011

Ther Adv Neurol Disord

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Nonconvulsive status epilepticus (NCSE) comprises a group of syndromes that display a great diversity regarding response to anticonvulsants ranging from virtually self-limiting variants to entirely refractory forms. Therefore, treatment on intensive care units (ICUs) is required only for a selection of cases. The aetiology and clinical form of NCSE are strong predictors for the overall prognosis. Absence status epilepticus is commonly seen in patients with idiopathic generalized epilepsy and is rapidly terminated by low-dose of benzodiazepines. The management of complex partial status epilepticus is straightforward in patients with preexisting epilepsy, but poses major problems if occurring in the context of acute brain lesions. Subtle status epilepticus represents the late stage of undertreated previous overt generalized convulsive status epilepticus and always requires aggressive ICU treatment. Within the intensive care setting, the diagnostic challenge may be seen in the difficulty in delineating nonepileptic conditions such as posthypoxic, metabolic or septic encephalopathies from NCSE. Although all important forms are considered, the focus of this review lies on clinical presentations and electroencephalogram features of comatose patients treated on ICUs and possible diagnostic pitfalls.

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“…Patients with partial SE typically fare less well because the outcome is etiology-dependent and the SE tends to recur and be more difficult to abolish [19,20].…”

Section: Benign Epileptic Nonconvulsive Status Epilepticusmentioning

confidence: 99%

Treatment of Acute Seizures and Status Epilepticus

Costello

Cole

2007

J Intensive Care Med

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Overt status epilepticus and persistent obtundation after a witnessed clinical seizure are neurologic emergencies. Early recognition and intervention in the electroclinical syndrome of status epilepticus reduces morbidity, although treatment of the underlying etiology is also critical. This review outlines key concepts related to status epilepticus, delineates an approach to the early management of status epilepticus, and highlights novel but practical approaches in the evaluation and treatment of refractory status epilepticus, emphasizing the use of a treatment algorithm. This review is written from the perspective of the intensive care unit clinician, and the approach and opinions expressed stem from clinical experience and review of the current literature. Particular attention is given to an overall approach to the management of convulsive status epilepticus in adults and older children as well as exploring novel approaches and diagnostic tools that may prove useful in difficult-to-control status epilepticus.

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Simple partial status epilepticus: causes, treatment, and outcome in 47 patients.

Cited by 27 publications

References 9 publications

Focal Status Epilepticus: Clinical Features and Significance of Different EEG Patterns

Focal Status Epilepticus: Clinical Features and Significance of Different EEG Patterns

Nonconvulsive status epilepticus: a diagnostic and therapeutic challenge in the intensive care setting

Treatment of Acute Seizures and Status Epilepticus

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