Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

OBJECTIVE: Nonconvulsive status epilepticus (NCSE) is currently considered as one of the most frequent types of status epilepticus (SE). The objective of the present study was to identify the natural history of the electrographical evolution of refractory NCSE and to establish the relationship betwe...

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Bibliographic Details
Authors: Liberalesso, Paulo Breno Noronha [UNIFESP], Garzon, Eliana [UNIFESP], Yacubian, Elza Márcia Targas [UNIFESP], Sakamoto, Américo Ceiki [UNIFESP]
Format: article
Status:Published version
Publication Date:2012
Country:Brasil
Institution:Universidade Federal de São Paulo (UNIFESP)
Repository:Repositório Institucional da UNIFESP
Language:English
OAI Identifier:oai:repositorio.unifesp.br:11600/7196
Online Access:http://dx.doi.org/10.1590/S0004-282X2012000700006
http://repositorio.unifesp.br/handle/11600/7196
Access Level:Open access
Keyword:nonconvulsive status epilepticus
ictal patterns
PLEDs
estado de mal epiléptico não convulsivo
padrões ictais
Description
Summary:OBJECTIVE: Nonconvulsive status epilepticus (NCSE) is currently considered as one of the most frequent types of status epilepticus (SE). The objective of the present study was to identify the natural history of the electrographical evolution of refractory NCSE and to establish the relationship between ictal patterns and prognosis. METHODS: We analyzed, retrospectively, 14 patients with loss of consciousness and NCSE. The ictal patterns were classified as discrete seizures (DS), merging seizures (MS), continuous ictal discharges (CID), continuous ictal discharges with flat periods (CID-F), and periodic lateralized epileptiform discharges (PLEDs). RESULTS: The ictal patterns were DS (n=7; 50.0%), PLEDs (n=3; 1.4%), CID (n=2; 14.3%), MS (n=1; 7.1%), and CID-F (n=1; 7.1%). CONCLUSIONS: NCSE electrographic findings are heterogeneous and do not follow a stereotyped sequence. PLEDs were related to a higher probability of neurological morbidity and mortality.