PMID- 18459630
OWN - NLM
STAT- MEDLINE
DCOM- 20080722
LR  - 20220419
IS  - 1086-508X (Print)
IS  - 1086-508X (Linking)
VI  - 48
IP  - 1
DP  - 2008 Mar
TI  - Diagnosis of nonconvulsive status epilepticus (NCSE) in adults with altered 
      mental status: clinico-electroencephalographic considerations.
PG  - 11-37
AB  - The high incidence of nonconvulsive status epilepticus (NCSE) and difficulties 
      encountered in rapid diagnosis have only recently become apparent and most 
      neurophysiology textbooks have yet to fully address this topic. There is an 
      immediate need to provide neurologists, neurology residents, and 
      electroneurodiagnostic technologists with information to assist them in achieving 
      early, accurate diagnosis of NCSE in patients they encounter on a daily basis. 
      Instead of attempting to write a comprehensive review of the topic, we examined 
      over 90 NCSE publications since 1972 and focused our efforts on extracting and 
      summarizing those EEG and clinical considerations we found most useful for 
      accurate diagnosis of NCSE in an adult population. The wide overlap between the 
      clinical symptoms of NCSE and many other disorders causing change in mental 
      status limits the usefulness of clinical measures for diagnosis. Those clinical 
      parameters which have some utility are outlined. EEG testing and accurate 
      interpretation is needed to identify NCSE in most instances. EEG patterns of NCSE 
      are detailed and examples provided in order of progressive complexity. Timely 
      treatment reduces patient risk for morbidity attributed to NCSE. 
      Electroneurodiagnostic technologists who learn to recognize the entire spectrum 
      of NCSE EEG patterns are better able to alert electroencephalographers to EEGs 
      likely needing expedited review. This may facilitate early diagnosis if 
      electroencephalographers determine that NCSE is indeed present. 
      Electroencephalographers correlate the EEG pattern, clinical activity, and other 
      diagnostic information to provide the treating medical doctors with an 
      interpretation and recommendation in a timely manner. Lastly, EEG and clinical 
      checklists and an algorithm which uses benzodiazepine response in conjunction 
      with continuous EEG monitoring are provided to help reduce uncertainty in 
      interpretation of equivocal EEG patterns of NCSE.
FAU - Bearden, Scott
AU  - Bearden S
AD  - Clinical Neurophysiology Laboratory/Neurology Services, North Florida/South 
      Georgia Veterans Health System, Gainesville, Florida, USA.
FAU - Eisenschenk, Stephan
AU  - Eisenschenk S
FAU - Uthman, Basim
AU  - Uthman B
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Electroneurodiagnostic Technol
JT  - American journal of electroneurodiagnostic technology
JID - 9607038
SB  - IM
MH  - Clinical Protocols/standards
MH  - Early Diagnosis
MH  - Electroencephalography/standards
MH  - Humans
MH  - Mental Disorders/physiopathology
MH  - Neurologic Examination/*standards/trends
MH  - Seizures/physiopathology
MH  - Status Epilepticus/*diagnosis/*physiopathology
RF  - 63
EDAT- 2008/05/08 09:00
MHDA- 2008/07/23 09:00
CRDT- 2008/05/08 09:00
PHST- 2008/05/08 09:00 [pubmed]
PHST- 2008/07/23 09:00 [medline]
PHST- 2008/05/08 09:00 [entrez]
PST - ppublish
SO  - Am J Electroneurodiagnostic Technol. 2008 Mar;48(1):11-37.