Pedro Beleza1, João Rocha, João Pinho. 1. *EEG Unit, Department of Neurology, Luz Saude-Arrabida Hospital and Clipovoa, Póvoa de Varzim †Department of Neurology, Braga Hospital, Braga, Portugal.
Abstract
BACKGROUND: Nonconvulsive status epilepticus (NCSE) defines a prolonged electrographic seizure activity resulting in nonconvulsive symptoms. Semiology is a crucial element in diagnosis, etiological evaluation, and treatment plan of NCSE. It includes mostly generalized myoclonic status (GMS), focal simple motor status (FSMS), and dyscognitive status (DS). REVIEW SUMMARY: This review aims to guide clinicians in diagnosis, etiological evaluation, and treatment of patients with NCSE based on semiological presentation. CONCLUSIONS: Diagnosis of GMS and FSMS is based mainly on semiology, whereas DS often requires EEG for differential diagnosis with nonepileptic events. GMS and FSMS etiological investigation may be readily prioritized based on semiological type, whereas DS requires EEG for further classification in psychomotor status and absence status. Choice of appropriate treatment is dictated by the semiological presentation, EEG findings, and etiology. Surgery and other interventions including electroconvulsive therapy and vagal nerve stimulation should be considered in patients refractory to medical treatment.
BACKGROUND:Nonconvulsive status epilepticus (NCSE) defines a prolonged electrographic seizure activity resulting in nonconvulsive symptoms. Semiology is a crucial element in diagnosis, etiological evaluation, and treatment plan of NCSE. It includes mostly generalized myoclonic status (GMS), focal simple motor status (FSMS), and dyscognitive status (DS). REVIEW SUMMARY: This review aims to guide clinicians in diagnosis, etiological evaluation, and treatment of patients with NCSE based on semiological presentation. CONCLUSIONS: Diagnosis of GMS and FSMS is based mainly on semiology, whereas DS often requires EEG for differential diagnosis with nonepileptic events. GMS and FSMS etiological investigation may be readily prioritized based on semiological type, whereas DS requires EEG for further classification in psychomotor status and absence status. Choice of appropriate treatment is dictated by the semiological presentation, EEG findings, and etiology. Surgery and other interventions including electroconvulsive therapy and vagal nerve stimulation should be considered in patients refractory to medical treatment.
Authors: Vanessa Benjumea-Cuartas; Monika Eisermann; Hina Simonnet; Marie Hully; Rima Nabbout; Isabelle Desguerre; Anna Kaminska Journal: Epilepsy Behav Case Rep Date: 2017-01-18