Nonconvulsive status epilepticus during childhood: clinical and electroencephalographic features
Yüksel Yılmaz, Oğuzhan Onultan, Mustafa Berber
Division of Child Neurology, Department of Pediatrics, Marmara University Faculty of Medicine, İstanbul, Turkey
Yılmaz Y, Onultan O, Berber M. Nonconvulsive status epilepticus
during childhood: clinical and electroencephalographic features. Turk J Pediatr
2008; 50: 449-455.
Nonconvulsive status epilepticus (NCSE) is a medical emergency, which
is diagnosed most frequently with the routine use of EEG in the pediatric
emergency and intensive care units.
Data from eight patients, ranging from 2.8-15 years old (median 8.7 years),
treated with the diagnosis of NCSE were evaluated on clinical basis. The
patients attended the hospital with acute confusional state ranging from
sudden onset of verbal cooperation insufficiency to aimless-meaningless
behavior and confusion without any motor component of seizure. While five
of the cases were diagnosed and followed up with epilepsy, the other three
had no history of epilepsy. No reason was detected that could cause acute
encephalopathy. EEG examinations during acute confusional state showed
partial or generalized continuous electrographic seizure activity lasting at
least 30 minutes without clinical seizure activity. After administration of
intravenous antiepileptic medication, the confusional states of the patients
recovered, and the EEG examinations showed normal baseline activity with
significantly diminished discharges or complete normal waveform.
Nonconvulsive status epilepticus should be considered in all children admitted
to the hospital with acute unexplained encephalopathy, whether they have a
history of epilepsy or not. Emergent EEG examination should be a routine part
of evaluation in these children for the diagnosis and treatment of NCSE.