PMID- 8681896
OWN - NLM
STAT- MEDLINE
DCOM- 19960820
LR  - 20220321
IS  - 0013-9580 (Print)
IS  - 0013-9580 (Linking)
VI  - 37
IP  - 7
DP  - 1996 Jul
TI  - Nonconvulsive status epilepticus in the emergency room.
PG  - 643-50
AB  - PURPOSE: The study reviewed emergent cases of nonconvulsive status epilepticus 
      (NCSE) to evaluate causes of diagnostic and management delay and examined 
      frequent diagnostic features suggestive of NCSE. METHODS: In a retrospective 
      study, we assessed the clinical presentation of 23 patients with one or more NCSE 
      episodes, their medical history, EEG, and antiepileptic drug (AED) treatment. We 
      also evaluated causes of diagnostic delay in patients referred to the emergency 
      room (ER) in confusional states. RESULTS: There was considerable overlap in 
      clinical features of patients with complex partial SE (CPSE) and generalized 
      nonconvulsive SE (GNSE). Delays in seeking medical attention were common. 
      Diagnosis was significantly delayed in 10 patients. Three cases illustrate the 
      possible markedly different presentations of NCSE. CONCLUSIONS: NCSE often goes 
      unrecognized or is mistaken for behavioral or psychiatric disturbance. The 
      pleomorphic clinical presentation of NCSE indicates that EEG and a therapeutic 
      trial of AEDs afford the best diagnostic measures in acute waxing and waning 
      confusional states associated with agitation, bizarre behavior, staring, 
      increased tone, mutism, or subtle myoclonus.
FAU - Kaplan, P W
AU  - Kaplan PW
AD  - Johns Hopkins Bayview Medical Center, Department of Neurology, Johns Hopkins 
      School of Medicine, Baltimore, Maryland, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
RN  - 0 (Anticonvulsants)
RN  - O26FZP769L (Lorazepam)
RN  - Q3JTX2Q7TU (Diazepam)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/therapeutic use
MH  - Confusion/diagnosis
MH  - Diagnosis, Differential
MH  - Diazepam/therapeutic use
MH  - Drug Therapy, Combination
MH  - Electroencephalography
MH  - *Emergency Service, Hospital
MH  - Epilepsy, Complex Partial/diagnosis/psychology
MH  - Epilepsy, Generalized/diagnosis/psychology
MH  - Female
MH  - Humans
MH  - Lorazepam/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Mutism/diagnosis
MH  - Retrospective Studies
MH  - Status Epilepticus/*diagnosis/drug therapy/psychology
MH  - Treatment Outcome
EDAT- 1996/07/01 00:00
MHDA- 1996/07/01 00:01
CRDT- 1996/07/01 00:00
PHST- 1996/07/01 00:00 [pubmed]
PHST- 1996/07/01 00:01 [medline]
PHST- 1996/07/01 00:00 [entrez]
AID - 10.1111/j.1528-1157.1996.tb00628.x [doi]
PST - ppublish
SO  - Epilepsia. 1996 Jul;37(7):643-50. doi: 10.1111/j.1528-1157.1996.tb00628.x.