The Clinical Features, Diagnosis, and Prognosis of Nonconvulsive Status Epilepticus

Abstract

Nonconvulsive status epilepticus (NCSE) is a state of ongoing seizure activity for at least 30 minutes, with cognitive or behavioral changes, but without convulsive clinical manifestations. It requires EEG for confirmation. It has been categorized into groups having focal or generalized EEG epileptic activity; and by etiology and level of consciousness (which predict outcome). Points of contention include the evolving definition of what constitutes NCSE, various reasons for a delayed, missed, or misidentified diagnosis, and the optimal management of these conditions.

Pseudo Continuous Arterial Spin Labeling MR Imaging of Status Epilepticus

“…Three patients presented with acute symptomatic tonic-clonic seizures; the other three patients had atypical manifestations such as headache, hallucination, or altered mentality. All cases were definitely diagnosed as CSE or NCSE by the treating medical team (26,27). With the exception of patient 1, all EEG data were obtained during the ictal period.…”

Non-convulsive status epilepticus in adults - an overview

“…In general, NCSE in adults is subdivided into the two main groups of focal and generalised NCSE, where simple-partial SE (SPSE) and CPSE, and AS are the principal types, respectively [37]. The most recent proposal of classification has been created by a group of foremost experts in the field of epilepsy on behalf of the ILAE [14].…”

A Descriptive Analysis of Prognostic Indicators in Patients with Non-Convulsive Status Epilepticus in a Tertiary Hospital Population

“…Most recognize NCSE as continuous or nearly continuous electrographic seizure activity associated with an alteration in mental state of at least 30 minutes, and occurring in the absence of frank convulsions [1][2][3]. The diagnosis is increasingly recognized with the advent of long term EEG monitoring and heightened physician awareness, although the incidence is still underestimated and constitutes at least one quarter of cases of status epilepticus [4,5].…”

“…Morbidity and mortality estimates for NCSE depend greatly on the epidemiology of the population studied, the definition of NCSE used, and seizure etiology [2]. In the hospital setting, NCSE tends to be associated with marked morbidity (39%) and mortality (18%) [14].…”