Electroencephalographic behavior of non-convulsive status epilepticus in patients with altered consciousness in a single tertiary care level hospital.
Abstract number :
2.372
Submission category :
3. Neurophysiology / 3C. Other Clinical EEG
Year :
2016
Submission ID :
228151
Source :
www.aesnet.org
Presentation date :
12/4/2016 12:00:00 AM
Published date :
Nov 21, 2016, 18:00 PM
Authors :
Julio Jose Macias Gallardo, Instituto Nacional de Ciencias Medicas y Nutricialvador Zubiran; Laura Georgina Mendoza Olivas, Instituto Nacional de Ciencias Medicas y Nutricialvador Zubiran; and Horacio Senties Madrid, Instituto Nacional de Ciencias Medicas
Rationale: Purpose: Determine how often non-convulsive SE was detected by EEG in patients with altered consciousness and associate electroencephalographic patterns, etiology and survival in patients with NCSE diagnosis. Methods: Retrospective cohort study involving 66 clinical suspicion patients of NCSE (year 2009-2016) in a tertiary care level hospital. Results: 15/66 patients (23%) were diagnosed with NCSE by EEG. The etiologies were divided as follows:1 acute medical cause (AMC), 2 epilepsy, 3 cryptogenic. Median age: 57 years old (19-88), 11 women. 10/15 patients were AMC (5 neuroinfection, 1 metabolic, 1 SLE and 3 CVD). Three were in the epilepsy group and 2 were of cryptogenic cause. Mortality: 8/15 died, 5/10 were in the AMC group, 1/3 epilepsy group and 2/2 cryptogenic cause.5 patients died because of multiorganic failure and not due to NCSE itself. Three presented with rapidly progressive dementia-probable Creutzfeldt-Jakob disease- based on ancillary studies without histopathologic confirmation. EEG patterns found: periodic (7), slow generalized waves with electroclinical response to benzodiazepines (2), spikes and sharp waves (6).. Conclusions: NCSE is a not well described disease with high mortality. In this sample, the percentage detected by EGG was high (23 %) other authors had described 7-36%, so a high suspicion of NCSE should be maintained in patients with altered consciousness. the mortality is high and influenced because of the severity of the disease in this patients. It is important for the physician to recognize the electroencephalographic patterns associated to NCSE other than traditional epileptiform discharges, such as generalized slow waves with electroclinical response to benzodiazepines in order to establish prompt treatment. Bibliography Towne AR , Waterhouse EJ, Boggs JG at al. Prevalence of nonconvulsive status epilepticus in comatose patients NEUROLOGY 2000;54:340–345. Privitera M, Hoffman M, Layne Moore J at al. EEG detection of nontonic-clonic status epilepticus in patients with altered consciousness Epilepsy Research, 1994; 18: 155-166. Funding: No funding
Neurophysiology