Etiology and prognosis of non-convulsive status epilepticus

Kang, Bong Su; Jhang, Yunsook; Kim, Youngsoo; Moon, Jangsup; Shin, Jung-Won; Moon, Hee Bom; Lee, Sang Kun; Jung, Keun‐Hwa; Chu, Kon; Park, Kyung‐Il

doi:10.1016/j.jocn.2014.03.018

Cited by 30 publications

(43 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is likely that it is due to previous silent infarcts and underlying Alzheimer's disease. Time from symptom onset to treatment of 12 days and from admission to treatment of 5 days are close to the recently reported durations in a retrospective review of NCSE in a major hospital . Diagnosis of NCSE is challenging especially in elderly adults because it can mimic delirium and such patients can easily have a CAM score of 3 or greater, which is suggestive of delirium .…”

supporting

confidence: 75%

Refusal to Eat as the Initial Manifestation of Nonconvulsive Status Epilepticus—Need for Clinical Vigilance

Shea

Cheng

Lee

et al. 2016

J American Geriatrics Society

View full text Add to dashboard Cite

supporting

confidence: 75%

Refusal to Eat as the Initial Manifestation of Nonconvulsive Status Epilepticus—Need for Clinical Vigilance

Shea

Cheng

Lee

et al. 2016

J American Geriatrics Society

View full text Add to dashboard Cite

“…Klinik özellikleri nonspesifiktir. Bu yüzden genellikle göz ardı edilir veya psikiyatrik hastalık olarak yanlış tanı alır (1). Bizim çalışmamızda 9 hastadan 6'ında inme sonrası semptomatik nöbet olmasına ve klinik nöbetleri kontrol altında olmasına rağmen, 6 hastada apati, 2 hastada ajitasyon ve 1 hastada uykuya eğilim şeklinde gelişen klinik bulgular saptandı.…”

Section: Discussionunclassified

“…NKSE için prognoz altta yatan nedene ve bilinçteki etkilenim düzeyine bağımlı gibi görünmektedir (1,21). Shneker ve ark'nın 2003'de yaptıkları 100 olguluk bir seride mortalite %18 olarak bulunmuştur (22).…”

Section: Discussionunclassified

“…Hızlı tanı ve tedavi edilme gerekmesine rağmen; klinik özellikleri spesifik ve belirgin değildir. Bu nedenle sıklıkla atlanılabilir veya davranışsal veya psikiyatrik rahatsızlıklar şeklinde yanlış tanı alabilir (1).…”

Section: Introductionunclassified

“…Prognoz sadece NKSE'un ayrıntılı tipine bağlı değil, aynı zamanda bilinç düzeyine de bağlıdır. İyi sonuçlar erken ve etkili tedaviye bağlı olabilir (1). NKSE etyolojisinde santral sinir sistemi infeksiyonları, metabolik nedenler, ciddi sistemik hastalıklar, hipoksi ve kafa travmasının yanında iskemik ve hemorajik inme de rol oynamaktadır.…”

Section: Introductionunclassified

See 2 more Smart Citations

Post stroke late onset Non-convulsive status epilepticus: analysis of 9 cases

Göksu¹,

Genç²,

Atis³

et al. 2016

Türk Beyin Damar Hast Derg

View full text Add to dashboard Cite

Antalya Eğitim ve Araştırma Hastanesi, Nöroloji Kliniği, ANTALYA ÖZET AMAÇ: Non konvulsif status epileptikus (NKSE) klinik özellikleri belirgin olmamasına ve sıklıkla göz artı edilmesine rağmen hızlı tanı ve tedavi edilmesi gereken bir durumdur. Etyolojisinde inmenin de rol oynadığı bu durumda inme hastalarında geç dönemde gözlenen NKSE olgularını incelemeyi amaçladık. GEREÇ ve YÖNTEM: Ocak 2013 ve Ocak 2016 tarihleri arasında inme polikliniğinde takip edilen hastalar retrospektif olarak değerlendirildi. İnmenin 1 hafta sonrasında NKSE tanısı alan hastalar geç dönem olarak tanımlandı. Toplam 9 hasta değerlendirildi. Tüm hastaların demografik özellikleri, inme etyolojisi, görüntüleme yöntemleri, Elektroensefalografi (EEG) bulguları, İnme şiddeti Ulusal Sağlık Enstitüleri (NIH) inme ölçeği (NIHSS) skoru fonksiyonel özürlülük modifiye Rankin Skalası (mRS) kayıt edildi. BULGULAR: Toplam 9 hasta değerlendirildi. Yas ortalamasi 70,5± 9,6 idi. Hastalardan 8 (%88,9) 'i kadin, 1'i erkekdi. Hastalarin tumu iskemik inme idi. Hastalarin 8' inde (%88,9) orta serebral arter (OSA) sulama alaninda, 1'inde posterior serebral arter (PSA) sulama alaninda infarkt mevcuttu. hastalarin 5'i (%55,6) kardiyoembolik inme, 4'u (%44,4) kriptojenik inme idi. SONUÇ: İskemik inme sonrası geç dönemde NKSE gözlenmesi hiç de nadir değildir. Yaşlı ve geniş enfarktı olan apatik hastalarda NKSE ayırıcı tanıda akılda tutulmalıdır. Anahtar Sözcükler: Nonkolvusif status epileptikus, inme sonrası nöbet, stroke, nöbet. POST STROKE LATE ONSET NON-CONVULSIVE STATUS EPILEPTICUS: ANALYSIS OF 9 CASESABSTRACT OBJECTIVE: Non-convulsive status epilepticus is a condition that needs timely diagnosis and treatment with insignificant clinical features and high risk of misdiagnosis. We aimed to reveal late onset NCSE in patients with stroke where stroke plays a role in the etiology. METHODS: We conducted a retrospective analysis of patients who presented to our outpatient stroke clinic between January 2013 to January 2016. A week after the stroke, patients were defined as late onset NCSE. A total of 9 patients were included. Demographic properties, stroke etiology, imaging modality, EEG findings, stroke severity according to NIHSS score, functional disability, modified Rankin Scale were recorded for all patients. RESULTS: A total of 9 patients were included. The mean age of the study population was 70,5± 9,6 years. There were 8 (88,9%) females, and 1 male. Eight of nine patients had middle cerebral artery, 1 patient had posterior cerebral artery infarct. While 5 patients had cardioembolic stroke, 4 patients had cryptogenic stroke. CONCLUSION: The late onset NCSE after ischemic stroke is not a rare entity. NCSE should be kept in the differential diagnosis of apathy patients with older age and large stroke.

show abstract

Prevalence of non‐convulsive seizures and electroencephalographic abnormalities in critically ill patients—A retrospective observational study

Karki,

Shrestha,

Shrestha

et al. 2023

Epilepsia Open

View full text Add to dashboard Cite

ObjectiveElectroencephalographic (EEG) abnormalities especially non‐convulsive status epilepticus (NCSE) have been found to be associated with worse outcomes in critically ill patients. We aimed to assess the prevalence of non‐convulsive seizures and electroencephalographic abnormalities in critically ill patients. Furthermore, we aimed to investigate any association between the type of EEG abnormality and outcomes including ICU mortality and successful ICU discharge.MethodsThis was a cross‐sectional observational study carried out among critically ill patients in a mixed medical‐surgical ICU from January 1, 2018 to May 15, 2020. A total of 178 records of 30 min bedside EEG records were found. EEG findings were grouped as normal, non‐convulsive seizures (NCS), non‐convulsive status epilepticus (NCSE), and other abnormalities. Descriptive analytical tools were used to characterize the case details in terms of the type of EEG abnormalities. Chi square test was used to describe the EEG abnormalities in terms of mortality. The status epilepticus severity scores (STESS) were further calculated for records with NCSE. These data were then analyzed for any association between STESS and mortality for cases with NCSE.ResultsThe prevalence of EEG abnormality in our cohort of all critically ill patients was found to be 7.3% (170/2234). Among the patients with altered sensorium in whom EEG was done, 42.9% had non‐conclusive seizure activity with 25.2% in NCSE. Though the study was not adequately powered, there was a definite trend towards a lower proportion of successful ICU discharge rates seen among patients with higher STESS (>2) with only 33.3% being discharged for patients with a STESS of 6 versus 92.9% for those with STESS 3.SignificanceWhen combined with a strong clinical suspicion, even a 30‐min bedside EEG can result in detection of EEG abnormalities including NCS and NCSE. Hence, EEG should be regularly included in the evaluation of critically ill patients with altered sensorium.Plain Language SummaryElectroencephalographic (EEG) abnormalities and seizures can have high prevalence in critically ill patients. These abnormalities notably, non‐convulsive status epilepticus (NCSE) has been found to be associated with poor patient outcomes. This was a retrospective observational study analyzing 178 EEG records, from a mixed medical‐surgical ICU. The indication for obtaining an EEG was based solely on the clinical suspicion of the treating physician. The study found a high prevalence of EEG abnormalities in 96.5% in whom it was obtained with 42.9% having any seizure activity and 28.8% having NCSE. The study was not powered for detection of association of the EEG abnormalities with clinical outcomes. However, a definite trend towards decreased chances of successful discharge from the ICU was seen. This study used strong clinical suspicion in patients with altered sensorium to obtain an EEG. High detection rates of EEG abnormalities were recorded in this study. Hence, combination of clinical judgement and EEG can improve detection of EEG abnormalities and NCSE.

show abstract

Etiology and prognosis of non-convulsive status epilepticus

Cited by 30 publications

References 31 publications

Refusal to Eat as the Initial Manifestation of Nonconvulsive Status Epilepticus—Need for Clinical Vigilance

Refusal to Eat as the Initial Manifestation of Nonconvulsive Status Epilepticus—Need for Clinical Vigilance

Post stroke late onset Non-convulsive status epilepticus: analysis of 9 cases

Prevalence of non‐convulsive seizures and electroencephalographic abnormalities in critically ill patients—A retrospective observational study

Contact Info

Product

Resources

About