Details
Category: Volume 4 Issue 08 August 2016
Hits: 1444

Title: Non-Convulsive Status Epilepticus in Emergency Department: A Diagnostic Challenge

Author: Ahmad Q. Hasan, MD

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i8.103

Abstract

Non-convulsive status epilepticus had always been a diagnostic dilemma to emergency physicians. The challenge falls in its elusive nature and the subtlety of physical findings. Understanding the essence this disease process and the approach to it will result into a rewarding outcome for the patient and the physician. In this brief review we are trying to shed some light on that ambiguous neurological emergency and try to come up with a facilitated way of dealing with this common source of morbidity and mortality.

References

 

1.      Dr. Hartmut Meierkord, MD, DR. Martin Holtkamp, MD. Non-convulsive status epilepticus in adults: clinical forms and treatment. The Lancet Neurology. Volume 6, Issue 4, April 2007, Pages 329–339.

2.      D.M. Treiman, P.D. Meyers, N.Y. Walton, J.F. Collins, C. Colling, A.J. Rowan, A. Handfort, E. Faught, A.P. Calabrese, B.M. Uthman, R.E. Ramsay, M.B. Mamdani. A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group. N. Engl. J. Med., 339 (1998), pp. 792–798.

3.      DeLorenzo RJ, Waterhouse EJ, Towne ARet al.Persistent nonconvulsive status epilepticus after the control of convulsive status epilepticus. Epilepsia1998; 39: 833–40.

4.      American College of Emergency Physicians. Clinical policy for the initial approach to patients presenting with altered mental status. Ann Emerg Med, 33 (1999), pp. 251–280

5.      Amish M Shah, Anita Vashi, Andy Jagoda,MD. Review article: Convulsive and non-convulsive status epilepticus: An emergency medicine perspective. Emergency Medicine Australia. Volume 21, Issue 5 October 2009 Pages 352–366.

6.      Kaplan PW. The clinical feature, diagnosis, and prognosis of nonconvulsive status epilepticus.Neurologist2005; 11: 348–61.

7.      Agathonikou A, Panayiotopoulos CP, Giannakodimos S, Koutroumanidis M. Typical absence status in adults: diagnostic and syndromic considerations. Epilepsia 1998; 39: 1265–76.

8.      Meierkord H, Holtkamp M. Non-convulsive status epilepticus in adults: clinical forms and treatment. Lancet Neurol. 2007; 6: 329–39.

9.      Drislane FW. Presentation, evaluation, and treatment of nonconvulsive status epilept-icus. Epilepsy Behav. 2000; 1: 301–314.

10.  M. Mansford, G.N. Fuller, J.P. Wade. “Silent diabetes”: non-ketotichyperglyc aemia presenting as aphasic status epilepticus. J NeurolNeurosurg Psychiatry, 59 (1995), pp. 99–100

11.  M. Okura, K. Okada, I. Nagamine, et al. Electroencephalographic changes during and after water intoxication. Jpn J Psychiatry Neurol, 44 (1990), pp. 729–734

12.  N. Eleftheriadis, E. Fourla, D. Eleftheriadis, A. Karlovasitou. Status epilepticus as a manifestation of hepatic encephalopathy. ActaNeurolScand, 107 (2003), pp. 142–144

13.  D.M. Ficker, B.F. Westmoreland, F.W. Sharbrough. Epileptiform abnormalities in hepatic encephalopathy. J Clin Neurophysiol, 14 (1997), pp. 230–234

14.  Saurina, M. Vera, M. Pou, A. Cases. Nonconvulsive status epilepticus in dialysis patients. Am J Kidney Dis, 39 (2002), pp. 440–441

15.  K.M. Chow, A.Y. Wang, A.C. Hui, T.Y. Wong, C.C. Szeto, P.K. Li. Nonconvulsive status epilepticus in peritoneal dialysis patients. Am J Kidney Dis, 38 (2001), pp. 400–405

16.  M. Tsuji, M. Tanaka, M. Yamakawa, R. Sagawa, H. Azuma. A case of systemic lupus erythematosus with complex partial status epilepticus. Epileptic Disord, 7 (2005), pp. 249–251

17.  J.L. Fernandez-Torre, M. Martinez-Martinez, J. Gonzalez-Rato, et al. Cephalosporin-induced nonconvulsive status epilepticus: clinical and electroen-cephalographic features. Epilepsia, 46 (2005), pp. 1550–1552

18.  Working Group on Status Epilepticus. Treatment of convulsive status epilepticus: recommendations of the Epilepsy Foundation of America's Working Group on Status Epilepticus. JAMA1993; 270: 854–9.

19.  Lowenstein DH, Bleck T, Macdonald RL. It's time to revise the definition of status epilepticus. Epilepsia1999; 40: 120–2.

20.  Costello DJ, Cole AJ. Treatment of acute seizures and status epilepticus. J Intensive Care Med.2007; 22: 319.

21.  Nevander G, Ingvar M, Auer R, Siesjo BK. Status epilepticus in well oxygenated rats causes neuronal necrosis. Ann. Neurol.1985; 18: 281–90.

22.  Lothman E. The biochemical basis and pathophysiology of status epilepticus. Neurology1990; 40 (Suppl2): 13–23.

23.  Treiman DM, Meyers PD, Walton NYet al. for the Veterans Affairs Status Epilepticus Cooperative Study Group. A comparison of four treatments for generalized convulsive status epilepticus. NEJM1998; 339: 792–8.

Corresponding Author

Ahmad Q. Hasan, MD