Nonconvulsive status epilepticus in adults: Electroclinical differences between proper and comatose forms

Fernández‐Torre, José L.; Rebollo, Mariano; Gutiérrez, Agustín; López-Espadas, Francisco; Hernández-Hernández, Miguel A.

doi:10.1016/j.clinph.2011.06.020

Cited by 39 publications

(47 citation statements)

References 74 publications

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“…30 Another more recent study compared NCSE proper to comatose NCSE. 31 Corresponding to the seizure forms in our study, the mortality rate was 6% and similar to our findings. Severe sequelae and death were most often caused by the underlying disease, as previously reported.…”

Section: Discussionsupporting

confidence: 92%

Adult nonconvulsive status epilepticus in a clinical setting: Semiology, aetiology, treatment and outcome

Power

Gramstad

Gilhus

et al. 2015

Seizure

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Section: Discussionsupporting

confidence: 92%

Adult nonconvulsive status epilepticus in a clinical setting: Semiology, aetiology, treatment and outcome

Power

Gramstad

Gilhus

et al. 2015

Seizure

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“…14,17 Unlike the previous study from a developing country where most of the patients had central nervous system infection and venous thrombosis, 14 in our series etiologies were mostly stroke, epilepsy and predominantly autoimmune encephalitis. This patient profile resembles those in developed countries, where most cases occur due to cerebrovascular disorders 8,10,12,17,19 or epilepsy, 12,19 after excluding hypoxic-ischemic encephalopathy. Autoimmune encephalitis was another common cause of NCSE in our NICU, making up 25% of the cases.…”

Section: Discussionmentioning

confidence: 78%

“…The mortality rate among critically ill cases is much higher (50% to 61%) 5,7,12 when compared with ambulatory patients (6% to 30%). 12,25 The following characteristics have been associated with mortality in SE: etiology, [5][6][7]9,13,[26][27][28] age, 9,26,28,29 the presence of acute life-threatening complications, 6,7 severe mental status impairment, [5][6][7]26,28 delay in diagnosis, 5 seizure duration, 5,27 and refractory SE. 28 Nonetheless, it has also been reported that duration 27,30 and type 26,27 of SE, gender, 26 time to treatment, 26 and presentation with coma 27 are not associated with mortality, especially once etiology is accounted for.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Features and Prognosis of Patients With Nonconvulsive Status Epilepticus in the Neurological Intensive Care Unit of a Tertiary Referral Center in Turkey

2013

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The availability of video electroencephalography monitoring (VEEGM) in neurological intensive care units has allowed the recognition and treatment of nonconvulsive status epilepticus (NCSE). However, little is known about characteristics, management, and outcomes in patients with NCSE in developing countries. We retrospectively reviewed the video-EEG reports of 120 patients who were monitored from November 2009 to March 2013. Indications for video-EEG were mostly unexplained alterations of consciousness or witnessed convulsive seizures. We identified the clinical characteristics, treatment regimes, and outcomes of patients with NCSE and tried to determine which parameters were associated with prognosis. NCSE was detected in 12/120 (10%) patients (3 females, 9 males; age 24-86 years). Admission diagnoses were: stroke (3), epilepsy (3), autoimmune limbic encephalitis (3), herpes encephalitis (1), presumed encephalitis-cardiac arrest (1), and malignancy (1). Eight patients had witnessed convulsive seizures before video-EEG. Interictal periodic epileptiform discharges were detected in 9 patients. In one-third of patients, ≥2 EEG recordings were required to capture seizures. In addition to anticonvulsants, 3 patients received immunosuppressive therapy, while intravenous anesthetics were given to 7 patients. Four patients (33.3%; 1 female, 3 males; age 51-67 years; etiology: stroke, autoimmune encephalitis, encephalitis-cardiac arrest, and malignancy; Glasgow coma scale (GCS) score <8 in 3 patients; all had periodic discharges; intravenous anesthetics were used) died in the intensive care unit. NCSE is not an infrequent finding in neurological intensive care units, thus necessitating prolonged video-EEG monitoring in patients at risk. Witnessed convulsions may indicate the presence of nonconvulsive seizures in patients with altered consciousness. Repeated recordings may increase the detection of ictal events. Periodic epileptiform discharges are commonly observed and may predict poor prognosis. Mortality seems to be influenced mostly by the underlying etiology.

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“…Only in the last few years the electroclinical differences between proper and comatose forms of SE have been emphasized [15, 16]. …”

Section: Discussionmentioning

confidence: 99%

Good Functional Outcome after Prolonged Postanoxic Comatose Myoclonic Status Epilepticus in a Patient Who Had Undergone Bone Marrow Transplantation

Accardo

Lisi

Lazzerini

et al. 2013

Case Reports in Neurological Medicine

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In anoxic coma, myoclonic status epilepticus and other nonreactive epileptiform patterns are considered as signs of poor prognosis. We report the case of a good recovery in a prolonged comatose myoclonic status epilepticus (MSE) after a cardiac arrest (CA) treated with mild therapeutic hypothermia (TH) in a patient who had undergone a bone marrow transplantation for Hodgkin's lymphoma. This case emphasizes the opportunity of performing an electroencephalogram (EEG) in the acute period after an hypoxic-ischemic insult and underlines the diagnostic difficulties between MSE and Lance-Adams syndrome, which classically occurs after the patient has regained consciousness, but can also begin while the patient is still comatose or sedated. Major problems in prognostication for postarrest comatose patients will also be pointed out.

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Nonconvulsive status epilepticus in adults: Electroclinical differences between proper and comatose forms

Cited by 39 publications

References 74 publications

Adult nonconvulsive status epilepticus in a clinical setting: Semiology, aetiology, treatment and outcome

Adult nonconvulsive status epilepticus in a clinical setting: Semiology, aetiology, treatment and outcome

The Clinical Features and Prognosis of Patients With Nonconvulsive Status Epilepticus in the Neurological Intensive Care Unit of a Tertiary Referral Center in Turkey

Good Functional Outcome after Prolonged Postanoxic Comatose Myoclonic Status Epilepticus in a Patient Who Had Undergone Bone Marrow Transplantation

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