Abstracts

RATIONALE: Complex partial status epilepticus (CPSE)is an uncommon cause of acute confusional state. Appropriate treatment can result in rapid improvement and often complete resolution of symptoms. We report three cases of CPSE. METHODS: Retrospective record review at the Neurology service of our medical center identified three patients with CPSE. RESULTS: All the patients were men with a mean age of 54 years (range 42-80 years). Duration of CPSE was four hours to 13 days. Two patients had prior hisotry of epilepsy but not for status epilepticus. Two patients had continuous form of CPSE and the third changed to intermittent form with treatment. Hyponatremia and change in anti-seizure medications may have contributed to CPSE. EEG confirmed the diagnosis. The response to intravenous lorazepam was favorable in clearing the symptoms and improving the EEG. One patient with prolonged CPSE was left with memory impairment while others returned to baseline. CONCLUSIONS: CPSE is often unrecognized by family members and or helath care provider thus resulting a delay in diagnosis and seeking of urgent medical care. Diagnosis of CPSE should be considered in patients with a prolonged acute or subacute onset confusional state and an EEG should be obtained promptly. This is especially true in patients with previous history of epilepsy.