Literature DB >> 11191930

No, some types of nonconvulsive status epilepticus cause little permanent neurologic sequelae (or: "the cure may be worse than the disease").

P W Kaplan1.   

Abstract

Nonconvulsive status epilepticus (NCSE) is characterized by a cognitive or behavioral change which lasts for at least 30 minutes, with EEG evidence of seizures. Although there is little argument that generalized nonconvulsive status epilepticus (GNSE) does not cause lasting deficits, there is still debate regarding the morbidity of complex partial status epilepticus (CPSE). Because the EEG is used for diagnosis, a strong argument can be made that NCSE is significantly under-recognized and diagnosed. Furthermore, since the documented cases of permanent neurologic sequelae are few, the potential permanent morbidity from CPSE may be significantly exaggerated. The literature indicates that comatose patients have a poor prognosis largely as a result of comorbid conditions and coma, whereas lightly obtunded or slightly confused patients with NCSE have little or no sequelae. Patients with NCSE may suffer (hypotension and respiratory suppression) from iatrogenic 'aggressive' treatment with intravenous anti-epileptic drugs (IV-AEDs), and the findings in the literature indicate that subjects treated with benzodiazepines may have a worse prognosis. The clinician must balance the potential but rare neurologic morbidity associated with NCSE against the not infrequent morbidity caused by IV-AEDs. Better stratification of the level of consciousness and comorbid conditions is needed when evaluating outcomes so as to clearly distinguish among the deficits due to: comorbid conditions; the effects of treatment and the effects of status epilepticus (SE) proper.

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Year:  2000        PMID: 11191930     DOI: 10.1016/s0987-7053(00)00238-0

Source DB:  PubMed          Journal:  Neurophysiol Clin        ISSN: 0987-7053            Impact factor:   3.734


  17 in total

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Authors:  Andrea O Rossetti; Daniel H Lowenstein
Journal:  Lancet Neurol       Date:  2011-10       Impact factor: 44.182

2.  Questionable direct association between ictal activity and thalamus lesions.

Authors:  Eugenio Grillo
Journal:  Neuroradiology       Date:  2010-11-19       Impact factor: 2.804

Review 3.  Refractory and super-refractory status epilepticus--an update.

Authors:  Sara Hocker; William O Tatum; Suzette LaRoche; W David Freeman
Journal:  Curr Neurol Neurosci Rep       Date:  2014-06       Impact factor: 5.081

4.  Posterior reversible encephalopathy syndrome: a truly treatable neurologic illness.

Authors:  Esther V Hobson; Ian Craven; S Catrin Blank
Journal:  Perit Dial Int       Date:  2012 Nov-Dec       Impact factor: 1.756

Review 5.  [Refractory status epilepticus: diagnosis, therapy, course, and prognosis].

Authors:  F Bösebeck; G Möddel; K Anneken; M Fischera; S Evers; E B Ringelstein; C Kellinghaus
Journal:  Nervenarzt       Date:  2006-10       Impact factor: 1.214

6.  Treatment options in the management of status epilepticus.

Authors:  Andrea O Rossetti
Journal:  Curr Treat Options Neurol       Date:  2010-03       Impact factor: 3.598

7.  Nonconvulsive status epilepticus: a diagnostic and therapeutic challenge in the intensive care setting.

Authors:  Martin Holtkamp; Hartmut Meierkord
Journal:  Ther Adv Neurol Disord       Date:  2011-05       Impact factor: 6.570

8.  Calculating the risk benefit equation for aggressive treatment of non-convulsive status epilepticus.

Authors:  Matthew Ferguson; Matt T Bianchi; Raoul Sutter; Eric S Rosenthal; Sydney S Cash; Peter W Kaplan; M Brandon Westover
Journal:  Neurocrit Care       Date:  2013-04       Impact factor: 3.210

9.  Status Epilepticus Severity Score (STESS): a tool to orient early treatment strategy.

Authors:  Andrea O Rossetti; Giancarlo Logroscino; Tracey A Milligan; Costas Michaelides; Christiane Ruffieux; Edward B Bromfield
Journal:  J Neurol       Date:  2008-09-03       Impact factor: 4.849

10.  Non-convulsive status epilepticus following antibiotic therapy as a cause of unexplained loss of consciousness in patients with renal failure.

Authors:  Savas Ozturk; Gonenc Kocabay; Baris Topcular; Halil Yazici; Arif Atahan Cagatay; Gulistan Bahat; Betul Baykan; Aydin Turkmen; Alaattin Yildiz
Journal:  Clin Exp Nephrol       Date:  2008-12-17       Impact factor: 2.801

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