Document Detail


Non-convulsive status epilepticus : Temporary fad or reality in need of treatment?
MedLine Citation:
PMID:  23192630     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The term non-convulsive status epilepticus (NCSE) refers to a heterogeneous group of diseases with different etiology, prognosis and treatment. The different forms of NCSE comprise about 25-50% of all status epilepticus cases. The most frequent form encountered in clinical practice is complex-partial SE but the rarer conditions of absence status, aura status and subtle SE are also included under this category. A diagnosis of NCSE should be considered in all patients with otherwise unexplained changes in consciousness or behavior and this diagnosis demands rapid further diagnostic work up including clinical examination, a detailed clinical history from the patient or an accompanying person, cranial computed tomography (CCT) and an electroencephalogram (EEG). If signs of an infectious or inflammatory disorder are present, a spinal tap is indicated. The EEG is of high relevance although interpretation can be challenging in NCSE.Absence status is usually treated by benzodiazepines and if necessary a broad spectrum anticonvulsive drug (ACD) such as valproic acid (VPA) can be added. The treatment of complex-partial SE follows the same scheme as that of generalized tonic-clonic SE and an initial benzodiazepine (i.v. lorazepam or intramuscular midazolam) followed by a bolus of one of the ACDs available as i.v. solution (e.g. VPA, phenytoin, phenobarbitol or levetiracetam). The third treatment step is general anesthesia if NCSE fails to be controlled. The aggressiveness of the applied therapy depends on the severity of the NCSE and the general condition of the patient. The prognosis is determined by the subtype of NCSE and the underlying etiology.
Authors:
F Rosenow; S Knake; H M Hamer
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-30
Journal Detail:
Title:  Der Nervenarzt     Volume:  -     ISSN:  1433-0407     ISO Abbreviation:  Nervenarzt     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400773     Medline TA:  Nervenarzt     Country:  -    
Other Details:
Languages:  GER     Pagination:  -     Citation Subset:  -    
Affiliation:
Epilepsiezentrum Hessen, Klinik für Neurologie, Universitätsklinikum Marburg und Philipps-Universität Marburg, Baldingerstr. 1, 35043, Marburg, Deutschland, rosenow@med.uni-marburg.de.
Vernacular Title:
Nonkonvulsiver Status epilepticus : Modeerscheinung oder behandlungspflichtige Realität?
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