PMID- 26092326
OWN - NLM
STAT- MEDLINE
DCOM- 20160329
LR  - 20220408
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 49
DP  - 2015 Aug
TI  - Salzburg Consensus Criteria for Non-Convulsive Status Epilepticus--approach to 
      clinical application.
PG  - 158-63
LID - S1525-5050(15)00258-9 [pii]
LID - 10.1016/j.yebeh.2015.05.007 [doi]
AB  - BACKGROUND: Salzburg Consensus Criteria for diagnosis of Non-Convulsive Status 
      Epilepticus (SCNC) were proposed at the 4th London-Innsbruck Colloquium on status 
      epilepticus in Salzburg (2013). METHODS: We retrospectively analyzed the EEGs of 
      50 consecutive nonhypoxic patients with diagnoses of nonconvulsive status 
      epilepticus (NCSE) at discharge and 50 consecutive controls with abnormal EEGs in 
      a large university hospital in Austria. We implemented the American Clinical 
      Neurophysiology Society's Standardized Critical Care EEG Terminology, 2012 
      version (ACNS criteria) to increase the test performance of SCNC. In patients 
      without preexisting epileptic encephalopathy, the following criteria were 
      applied: (1) more than 25 epileptiform discharges (ED) per 10-second epoch, i.e., 
      >2.5/s and (2) patients with EDs </= 2.5/s or rhythmic delta/theta activity (RDT) 
      exceeding 0.5/s AND at least one of the additional criteria: (2a) clinical and 
      EEG improvements from antiepileptic drugs (AEDs), (2b) subtle clinical phenomena, 
      or (2c) typical spatiotemporal evolution. In case of fluctuation without 
      evolution or EEG improvement without clinical improvement, "possible NCSE" was 
      diagnosed. For identification of RDT, the following criteria were compared: (test 
      condition A) continuous delta-theta activity without further rules, (B) ACNS 
      criterion for rhythmic delta activity (RDA), and (C) ACNS criteria for RDA and 
      fluctuation. RESULTS: False positive rate in controls dropped from 28% (condition 
      A) to 2% (B) (p = 0.00039) and finally to 0% (C) (p = 0.000042). Application of 
      test condition C in the group with NCSE gives one false negative (2%). Various 
      EEG patterns were found in patients with NCSE: (1) 8.2%, (2a) 2%, (2b) 12.2%, and 
      (2c) 32.7%. Possible NCSE was diagnosed based on fluctuations in 57.1% and EEG 
      improvement without clinical improvement in 14.2%. CONCLUSION: The modified SCNC 
      with refined definitions including the ACNS terminology leads to clinically 
      relevant and statistically significant reduction of false positive diagnoses of 
      NCSE and to minimal loss in sensitivity. This article is part of a Special Issue 
      entitled "Status Epilepticus".
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Leitinger, M
AU  - Leitinger M
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Centre for Cognitive Neuroscience, Salzburg, Austria. 
      Electronic address: markusleitinger@gmx.at.
FAU - Beniczky, S
AU  - Beniczky S
AD  - Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, 
      Denmark; Department of Clinical Neurophysiology, Aarhus University Hospital, 
      Denmark.
FAU - Rohracher, A
AU  - Rohracher A
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Centre for Cognitive Neuroscience, Salzburg, Austria.
FAU - Gardella, E
AU  - Gardella E
AD  - Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, 
      Denmark.
FAU - Kalss, G
AU  - Kalss G
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Centre for Cognitive Neuroscience, Salzburg, Austria.
FAU - Qerama, E
AU  - Qerama E
AD  - Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark.
FAU - Hofler, J
AU  - Hofler J
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Centre for Cognitive Neuroscience, Salzburg, Austria.
FAU - Hess Lindberg-Larsen, A
AU  - Hess Lindberg-Larsen A
AD  - Department of Clinical Neurophysiology, Aarhus University Hospital, Denmark.
FAU - Kuchukhidze, G
AU  - Kuchukhidze G
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Centre for Cognitive Neuroscience, Salzburg, Austria.
FAU - Dobesberger, J
AU  - Dobesberger J
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Centre for Cognitive Neuroscience, Salzburg, Austria.
FAU - Langthaler, P B
AU  - Langthaler PB
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Centre for Cognitive Neuroscience, Salzburg, Austria.
FAU - Trinka, E
AU  - Trinka E
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria; Centre for Cognitive Neuroscience, Salzburg, Austria. 
      Electronic address: e.trinka@salk.at.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150617
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Austria
MH  - *Consensus
MH  - Electroencephalography/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Practice Guidelines as Topic
MH  - Status Epilepticus/*diagnosis/physiopathology
MH  - Young Adult
OTO - NOTNLM
OT  - Diagnostic criteria
OT  - EEG
OT  - Nonconvulsive status epilepticus
OT  - Score
OT  - Status epilepticus
EDAT- 2015/06/21 06:00
MHDA- 2016/03/30 06:00
CRDT- 2015/06/21 06:00
PHST- 2015/05/02 00:00 [received]
PHST- 2015/05/04 00:00 [accepted]
PHST- 2015/06/21 06:00 [entrez]
PHST- 2015/06/21 06:00 [pubmed]
PHST- 2016/03/30 06:00 [medline]
AID - S1525-5050(15)00258-9 [pii]
AID - 10.1016/j.yebeh.2015.05.007 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2015 Aug;49:158-63. doi: 10.1016/j.yebeh.2015.05.007. Epub 2015 
      Jun 17.