PMID- 37661524
OWN - NLM
STAT- Publisher
LR  - 20231006
IS  - 0736-4679 (Print)
IS  - 0736-4679 (Linking)
VI  - 65
IP  - 4
DP  - 2023 Oct
TI  - Nonconvulsive Status Epilepticus: A Review for Emergency Clinicians.
PG  - e259-e271
LID - S0736-4679(23)00306-2 [pii]
LID - 10.1016/j.jemermed.2023.05.012 [doi]
AB  - BACKGROUND: Status epilepticus is associated with significant morbidity and 
      mortality and is divided into convulsive status epilepticus and nonconvulsive 
      status epilepticus (NCSE). OBJECTIVE: This review provides a focused evaluation 
      of NCSE for emergency clinicians. DISCUSSION: NCSE is a form of status 
      epilepticus presenting with prolonged seizure activity. This disease is 
      underdiagnosed, as it presents with nonspecific signs and symptoms, most commonly 
      change in mental status without overt convulsive motor activity. Causes include 
      epilepsy, cerebral pathology or injury, any systemic insult such as infection, 
      and drugs or toxins. Mortality is primarily related to the underlying condition. 
      Patients most commonly present with altered mental status, but other signs and 
      symptoms include abnormal ocular movements and automatisms such as lip smacking 
      or subtle motor twitches in the face or extremities. The diagnosis is divided 
      into electrographic and electroclinical, and although electroencephalogram (EEG) 
      is recommended for definitive diagnosis, emergency clinicians should consider 
      this disease in patients with prolonged postictal state after a seizure with no 
      improvement in mental status, altered mental status with acute cerebral pathology 
      (e.g., stroke, hypoxic brain injury), and unexplained altered mental status. 
      Assessment includes laboratory evaluation and neuroimaging with EEG. Management 
      includes treating life-threatening conditions, including compromise of the 
      airway, hypoglycemia, hyponatremia, and hypo- or hyperthermia, followed by rapid 
      cessation of the seizure activity with benzodiazepines and other antiseizure 
      medications. CONCLUSIONS: An understanding of the presentation and management of 
      NCSE can assist emergency clinicians in the care of these patients.
CI  - Published by Elsevier Inc.
FAU - Long, Brit
AU  - Long B
AD  - Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, 
      Texas. Electronic address: brit.long32@gmail.com.
FAU - Koyfman, Alex
AU  - Koyfman A
AD  - Department of Emergency Medicine, The University of Texas Southwestern Medical 
      Center, Dallas, Texas.
LA  - eng
PT  - Journal Article
DEP - 20230605
PL  - United States
TA  - J Emerg Med
JT  - The Journal of emergency medicine
JID - 8412174
SB  - IM
OTO - NOTNLM
OT  - NCSE
OT  - neurology
OT  - nonconvulsive status epilepticus
OT  - seizures
OT  - status epilepticus
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/09/04 06:43
MHDA- 2023/09/04 06:43
CRDT- 2023/09/04 01:00
PHST- 2022/11/30 00:00 [received]
PHST- 2023/04/01 00:00 [revised]
PHST- 2023/05/26 00:00 [accepted]
PHST- 2023/09/04 06:43 [pubmed]
PHST- 2023/09/04 06:43 [medline]
PHST- 2023/09/04 01:00 [entrez]
AID - S0736-4679(23)00306-2 [pii]
AID - 10.1016/j.jemermed.2023.05.012 [doi]
PST - ppublish
SO  - J Emerg Med. 2023 Oct;65(4):e259-e271. doi: 10.1016/j.jemermed.2023.05.012. Epub 
      2023 Jun 5.