Nonconvulsive Status Epilepticus in Adults.
Abstract number :
2.136
Submission category :
Year :
2001
Submission ID :
947
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
K. Niedzielska, MD, Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warsaw, Poland; D. Ryglewicz, Prof, Ist Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland; M. Baranska, MD, IInd Department of Neurology, Ins
RATIONALE: Nonconvulsive status epilepticus (NCSE) often presents diagnostic problems in adults, particularly in those without prior history of epilepsy (de novo NCSE). Therefore it is not always easy to recognize and the reports on its incidence are controversial.
The aim of this study was to analyze the frequency, etiology and EEG characteristics of NCSE in adult patients registered in hospital data bank.
METHODS: Among 3230 patients who were admitted to the Departments of Neurology in our Institute from September 1999 till March 2001, 42 patients presented status epilepticus (SE). Twenty seven patients (20 women and 7 men aged from 44 to 91 years, mean age 67.3) had clinical and EEG features of NCSE.
RESULTS: Out of 27 patients with NCSE only 4 patients had pre-existing epilepsy. On admission, complex partial or absence form of SE were diagnosed. Remaining 23 patients had de novo NCSE, in all of them complex partial NCSE was recognized. Eighteen of those patients (78%) were over 60 years old. SE occurred in the course of acute neurological diseases in 8 patients (stroke - 5, brain tumor - 3), in 12 patients with prior history of stroke, and in 3 patients with unknown etiology. In the group of 20 symptomatic patients, CT revealed multifocal lesions more frequently (80%) than isolated changes (20%), p [lt] 0.05. Generalized tonic-clonic seizures initiated the symptomatic NCSE in 12 patients, in contrary to complex partial seizures which appeared at the onset of NCSE in all cryptogenic cases.
CONCLUSIONS: NCSE seems to be a relatively frequent form of SE in adults, especially in elderly. Our results indicate that de novo NCSE occures more often in patients with multifocal brain lesions and that the most common form of its clinical presentation is complex partial SE.