Non-convulsive status epilepticus in the 21st century: clinical characteristics, diagnosis, treatment and prognosis.
Summary of "Non-convulsive status epilepticus in the 21st century: clinical characteristics, diagnosis, treatment and prognosis."
Non-convulsive status epilepticus is a significant issue for a neurologist because, despite its low prevalence, it mimics other pathologies, with therapeutics and prognostic outcomes. Diagnosis is based on clinical features, mainly mental status or impaired consciousness and electroencephalographic changes, so electroencephalogram is the first exploration we must perform with clinical suspicion. There are three clinical forms: generalized or absence status, with diffuse epileptiform discharges; focal, with epileptic discharges located in a specific brain area and may not affect consciousness; and subtle, with diffuse or local epileptic activity after a tonic-clonic seizure or convulsive status and limited or no motor activity. Treatment are benzodiazepines and antiepileptic drugs; anesthetic drugs are only recommended for patients with subtle status and in some with partial complex status. Prognosis is mainly determined by etiology and associated brain damage.
Affiliation
Clinica Universitaria de Navarra, 31008 Pamplona, Espana.
Journal Details
This article was published in the following journal.
Name: Revista de neurologia
ISSN: 1576-6578
Pages: 105-13
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22234569
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Status Epilepticus
A 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. (From N Engl J Med 1998 Apr 2;338(14):970-6; Neurologia 1997 Dec;12 Suppl 6:25-30)
History, 21st Century
Time period from 2001 through 2100 of the common era.
Influenza A Virus, H7n2 Subtype
A subtype of INFLUENZA A VIRUS comprised of the surface proteins hemagglutinin 7 and neuraminidase 2. It has been involved in a number of outbreaks in the 21st century on poultry farms and has been isolated a few times in humans.
Electroshock
Induction of a stress reaction in experimental subjects by means of an electrical shock; applies to either convulsive or non-convulsive states.
Paraldehyde
A hypnotic and sedative with anticonvulsant effects. However, because of the hazards associated with its administration, its tendency to react with plastic, and the risks associated with its deterioration, it has largely been superseded by other agents. It is still occasionally used to control status epilepticus resistant to conventional treatment. (From Martindale, The Extra Pharmacopoeia, 30th ed, p608-9)
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