Non-convulsive status epilepticus: mimics and chameleons

Kinney, Michael; Craig, John; Kaplan, Peter W.

doi:10.1136/practneurol-2017-001796

Cited by 28 publications

(20 citation statements)

References 72 publications

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“…Acute speech impairments, as aphasia, are commonly seen in epileptic attacks, 20 primary progressive aphasia (PPA), or strokes 21 . The change in NfL levels differs between the latter two conditions: the days following an ischemic or hemorrhagic neuronal damage are characterized by a progressive increase in blood NfL levels, 9 whereas patients with an aphasia related to a chronic neurodegenerative condition as PPA present only a minimal and slow increase in blood NfL 22 .…”

Section: Cognition and Speechmentioning

confidence: 99%

Neurological symptoms and blood neurofilament light levels

Barro

Zetterberg

2021

Acta Neurol Scand

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Neurofilament light chain (NfL), a component of the neuronal cytoskeleton, is increasingly recognized as promising biomarker in the clinical evaluation of neurological patients. 1,2 NfL is released from the neurons to the cerebrospinal fluid (CSF) and blood upon damage. Damage of the peripheral nervous system will also result in a release of NfL primarily into the blood. 3 The concentration in blood is approximately 50 times lower than in CSF, due to the proximity of CSF to the neuronal tissue. 4 Lately, highly sensitive assays enabled a reliable quantification of NfL in blood. 5 In our experience, the sensitivity and automation implemented with this technology enable the prospective and reliable evaluation of NfL levels in the blood of patients. 1 There is a high correlation between NfL levels measured in plasma and serum 6,7 and the evidence collected by plasma or serum measurements resulted to be consistent; thus, we refer in this review to blood NfL. Of note, the absolute NfL concentration is about 15% lower in EDTA plasma than serum; therefore, longitudinal comparisons of absolute values or with a reference range

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Section: Cognition and Speechmentioning

confidence: 99%

Neurological symptoms and blood neurofilament light levels

Barro

Zetterberg

2021

Acta Neurol Scand

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“…The most useful modality to identify a mimic is the use of continuous video EEG (cvEEG). 9 PNES (formerly known as "pseudoseizures") is most easily mistaken for SE, and is commonly associated with underlying psychiatric disorders such as depression, anxiety, and/or posttraumatic stress disorder. However, a significant proportion of patients have comorbid epilepsy, further complicating clinical assessment.…”

Section: Identificationmentioning

confidence: 99%

Status Epilepticus: Work-Up and Management in Adults

2020

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Status epilepticus is one of the most common neurological emergencies and is likely to have increasing prevalence in coming years given an aging “baby boomer” population in the United States. Because status epilepticus is associated with significant morbidity and mortality, identification and treatment are paramount. Care should be taken to exclude nonorganic mimics and infectious and metabolic causes. Status epilepticus can be classified into stages with associated recommendations for escalation in therapy, increasing from push-dose benzodiazepines to continuous anesthetic infusions and other nontraditional therapies. Concurrent electroencephalogram monitoring helps to identify, localize, and assess resolution of ictal patterns alongside antiseizure drug administration. A protocol is proposed for the management of status epilepticus in a step-wise fashion.

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“…1,3 EEG is an essential tool for the diagnosis of NCSE because the clinical signs (if even present) are often subtle, unclear, or nonspecific. 4,5 Although there are no evidence-based EEG standard criteria for NCSE, several proposals for a revised terminology and EEG classification of NCSE have been published. [6][7][8][9] This could be explained because similar patterns can be observed under various pathologic conditions, leading to substantial confusion in the literature, making EEG diagnosis a challenging matter.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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.

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Non-convulsive status epilepticus: mimics and chameleons

Cited by 28 publications

References 72 publications

Neurological symptoms and blood neurofilament light levels

Neurological symptoms and blood neurofilament light levels

Status Epilepticus: Work-Up and Management in Adults

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

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