Abstracts

Rationale: Nonconvulsive status epilepticus (NCSE) is defined as a mental status changes from baseline of at least 30 to 60 minutes duration associated with continuous or near continuous ictal discharges on EEG.Constitutes approximately 20 to 23% of status epilepticus cases. To diagnose NCSE there has to be, at the very least, EEG evidence of seizures. Without EEG, one can only guess at the cause of behavioral or cognitive change and the diagnosis of a NCSE remains speculative. Our aim is to describe patients with non-convulsive status epilepticus (NCSE) and assess associated factors with increased mortality and complications.Methods: Observational retrospective study of patients admitted for NCSE between 2008-2010. We analyzed demographic data, history of epilepsy, treatment, type of SENC and if any of the variables was associated with mortality and complications. Results: 30 patients (60% M). Mean age 62 years. History of epilepsy: 85% focal-onset epilepsy. 70% were symptomatic. 15% were caused by changes in medication. 17 patients had complex focal NCSE, 7 simplex focal and 6 absence status. 46.7% had complications (64% respiratory) and 6 patients died. No significant differences in complications and mortality in age, gender, type, etiology and treatment of epilepsy, or type of NCSE. 70% of patients were admitted to Intensive Care Unit (impairment level of consciousness and prolonged or refractory status) had complications compared with 30% of those not admitted in ICU (p <0.05). 17 patients were previously treated, 10 on monotherapy. 29.4% 1 st generation drugs, 41.2% 2nd generation and 29.4% both. Previously no treated patients: 85.7% initiated monotherapy (100% with 1st generation AED). Previously no treated patients:33.3% increased number of drugs, 33.3% kept it, 6% decreased. The most widely used drug on monotherapy was valproic (previous 50% discharged 40%) in combination and levetiracetam (previous 100% discharged 81%). Conclusions: Focal complex was the most frequent NCSE. There were more complications in patients with impairment of level of consciousness and prolonged or refractory status.