Non-convulsive status epilepticus: mimics and chameleons

Pract Neurol. 2018 Aug;18(4):291-305. doi: 10.1136/practneurol-2017-001796. Epub 2018 Apr 12.

Abstract

Non-convulsive status epilepticus (NCSE) is an enigmatic condition with protean manifestations. It often goes unrecognised, leading to delays in its diagnosis and treatment. The principal reason for such delay is the failure to consider and request an electroencephalogram (EEG), although occasional presentations have no scalp or surface electroencephalographic correlate. In certain settings with limited EEG availability, particularly out-of-hours, clinicians should consider treating without an EEG. Patients need a careful risk-benefit analysis to assess the risks of neuronal damage and harm versus the risks of adverse effects from various intensities of therapeutic intervention. Specialists in EEG, intensive care or epilepsy are invaluable in the management of patients with possible NCSE.

Keywords: intensive care; nonconvulsive status epilepticus; status epilepticus.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Electroencephalography
  • Female
  • Humans
  • Motor Activity
  • Status Epilepticus / diagnosis
  • Status Epilepticus / physiopathology*