Non-convulsive status epilepticus.

Abstract

The clinical, electrographic and reported neuropsychological features of 50 children with non-convulsive status epilepticus (NCSE) were reviewed and the children's progress followed for one to five years. NCSE occurred in a variety of epilepsies, especially the Lennox-Gastaut syndrome. Clinical manifestations ranged from obvious mental deterioration to subtle changes. The condition had often been overlooked or misinterpreted and many children had experienced repeated episodes over long periods. Following diagnosis, immediate treatment was often not attempted or was not successful. Further episodes of NCSE occurred in the majority of children during the follow up period. Failure to recognise NCSE and to treat episodes promptly, and the high rate of recurrence, is of particular concern in view of fears that repeated exposure to this condition might be brain damaging. At least 28 children in the present series showed evidence of intellectual or educational deterioration over the period during which NCSE had occurred, although the exact cause was difficult to determine.

Presentation, Evaluation, and Treatment of Nonconvulsive Status Epilepticus

“…Lorazepam may be the preferable drug (33). Nevertheless, there are clearly many cases in which the NCSE proves resistant (35,76). In a recent series of patients with NCSE where the foci were found to be primarily in frontal areas (45) there was often a delay of 2 days before diagnosis.…”

Practitioner Review: Assessment and Treatment of Sleep Disorders in Children and Adolescents

“…The excessive daytime sleepiness and other sleep complaints about children in the Munchausen syndrome by proxy (Griffith & Storik, 1989) may occur episodically. Neurological disorders of which intermittent excessive sleepiness or similar states are a part include tumour of the third ventricle and non-convulsive status epilepticus (Stores, Zaiwalla, Styles, & Hoshika, 1995). In the adolescent phase and later, excessive sleepiness (or insomnia) may occur in relation to menstruation (Billiard, Guilleminault, & Dement, 1975).…”

Do Nonconvulsive Seizures Damage the Brain?—Yes

“…54 Children with NCSE can suffer dementia or progressive cognitive deficits in the absence of progressive neurological disorders. 55,56 We have also observed patients who initially had normal IQs, and no definable neurodegenerative disease, who developed a severe dementia after years of frequent episodes of NCSE.…”