Abstracts

Rationale: Although nonconvulsive status epilepticus (NCSE) is an important type of epilepsy, the incidence in unknown, and clear etiology and recovery data for NCSE are lacking. We have analyzed the clinical characteristics and outcome in patients with NCSE in a tertiary epilepsy center.Methods: We examined the medical records of 34 patients with NCSE admitted to the Seoul National University Hospital between June 2005 and October 2008. NCSE was defined as a clinical presentation marked by altered awareness, with or without minor repetitive movements, plus electrographic seizures lasting more than 30 min with no intervening recovery of consciousness to the patient s baseline function. We reviewed the variables associated with the etiology and prognosis of NCSE. Results: The clinical details and EEG records of 34 adult NCSE patients (aged more than 16 years) were collected. All patients showed changes in mental status and had continuous or frequent epileptiform discharges on EEG recordings. Their mean age was 47 years (range, 16-89 years), and 20 were female. Ten patients (29.4%) had a history of epilepsy, and four (11.8%) hand a history of stroke. For 25 patients with acute medical of neurological problems, 15 patients had infections of central nervous system and five had various metabolic problems. The acute symptomatic etiology was associated with poor recovery (P=0.048). All NCSE patients received at least one antiepileptic drug, phenytoin being most frequently administered in 22 patients (64.7%). Despite aggressive treatment, eight (23.5%) of the 34 NCSE patients did not recover or died. Only nine patients (26.5%) were fully recovered.Conclusions: Our study shows that the presence of acute symptoms or central nervous infection is associated with poor outcome., suggesting that a high level of vigilance is required to identify and prevent complication.