The clinical presentation and encephalographic (EEG) findings of nonconvulsive status epilepticus (NCSE) can be complicated, making diagnosis difficult. There are generalized (e.g., absence status) and focal (e.g., aphasic status, complex partial status) forms. Some patients are responsive but have cognitive or other neurologic deficits; others are less responsive or even comatose. Increasingly, the diagnosis of NCSE is considered in intensive care unit patients. Here, without clinical signs of seizures such as convulsions, EEG is critical in diagnosis, but there is uncertainty about which EEG patterns represent seizures and which clinical situations and EEG patterns warrant aggressive treatment. Antiseizure medications are tailored to the NCSE type and the clinical condition. Treatment is often easier for NCSE, and the outcome better, than for convulsive SE, but this is not always true for critically ill patients with NCSE in the ICU, for whom continuous EEG monitoring is often crucial for diagnosis and management.
Nonconvulsive status epilepticus features with EEG monitoring in the neurological intensive care unit: a prospective study
