Status epilepticus
Status epilepticus is "prolonged seizure or seizures repeated frequently enough to prevent recovery between episodes occurring over a period of 20-30 minutes. The most common subtype is generalized tonic-clonic status epilepticus, a potentially fatal condition associated with neuronal injury and respiratory and metabolic dysfunction. Nonconvulsive forms include petit mal status and complex partial status, which may manifest as behavioral disturbances. Simple partial status epilepticus consists of persistent motor, sensory, or autonomic seizures that do not impair cognition (see also epilepsia partialis continua). Subclinical status epilepticus generally refers to seizures occurring in an unresponsive or comatose individual in the absence of overt signs of seizure activity."[1]
Classification
Epilepsia partialis continua
Generalized status epilepticus
Nonconvulsive status epilepticus
Nonconvulsive status epilepticus is an important cause of acute confusion or altered mental status.[2]
- Petit mal status
Petit mal status may cause behavioral disturbances.
- Complex partial status
Complex partial status may cause behavioral disturbances.
- Simple partial status
Simple partial status does not impair cognition.
- Subclinical status epilepticus
In subclinical status epilepticus the patient may be unresponsive or comatose and without overt signs of seizures.[1]
Diagnosis
The patients may only show atypical triphasic waves on their electroencephalogram.[3]
Epidemiology
One study found that 2 of 25 patients in the emergency room with mental status changes without obvious cause had nonconvulsive status epilepticus.[4] One third of elderly patients with nonconvulsive status have a history of epilepsy.[5]
References
- ↑ 1.0 1.1 Anonymous (2024), Status epilepticus (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Beyenburg S, Elger CE, Reuber M (2007). "Acute Confusion or Altered Mental State: Consider Nonconvulsive Status Epilepticus". Gerontology 53 (6): 150–158. DOI:10.1159/000106829. PMID 17684419. Research Blogging.
- ↑ Kaya D, Bingol CA (2007). "Significance of atypical triphasic waves for diagnosing nonconvulsive status epilepticus". Epilepsy Behav 11 (4): 567–77. DOI:10.1016/j.yebeh.2007.07.014. PMID 17942373. Research Blogging.
- ↑ Bautista RE, Godwin S, Caro D (2007). "Incorporating abbreviated EEGs in the initial workup of patients who present to the emergency room with mental status changes of unknown etiology". J Clin Neurophysiol 24 (1): 16–21. DOI:10.1097/WNP.0b013e318030e8cb. PMID 17277572. Research Blogging.
- ↑ Bottaro FJ, Martinez OA, Pardal MM, Bruetman JE, Reisin RC (2007). "Nonconvulsive status epilepticus in the elderly: a case-control study". Epilepsia 48 (5): 966–72. DOI:10.1111/j.1528-1167.2007.01033.x. PMID 17381437. Research Blogging.