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Review
. 2017 Sep 15:6:1690.
doi: 10.12688/f1000research.10939.1. eCollection 2017.

Novel clinical features of nonconvulsive status epilepticus

Masao Nagayama  1   2 , Sunghoon Yang  2 , Romergryko G Geocadin  3 , Peter W Kaplan  4 , Eisei Hoshiyama  5 , Azusa Shiromaru-Sugimoto  6 , Mitsuru Kawamura  6
Affiliations
Review

Novel clinical features of nonconvulsive status epilepticus

Masao Nagayama et al. F1000Res. .

Abstract

Nonconvulsive status epilepticus (NCSE) has rapidly expanded from classical features such as staring, repetitive blinking, chewing, swallowing, and automatism to include coma, prolonged apnea, cardiac arrest, dementia, and higher brain dysfunction, which were demonstrated mainly after the 2000s by us and other groups. This review details novel clinical features of NCSE as a manifestation of epilepsy, but one that is underdiagnosed, with the best available evidence. Also, we describe the new concept of epilepsy-related organ dysfunction (Epi-ROD) and a novel electrode and headset which enables prompt electroencephalography.

Keywords: electroencephalography; epilepsy; nonconvulsive status epilepticus.

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Conflict of interest statement

Competing interests: The authors declare that they have no competing interests.No competing interests were disclosed.No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Ictal electroencephalogram (EEG) in a patient with nonconvulsive status epilepticus (NCSE).
Ictal EEG of patient #8 in Table 1. This EEG was taken from an 83-year-old female with acute hyperammonemic encephalopathy resulting from Osler–Weber–Rendu disease. During the episode of NCSE with total aphasia, triphasic wave-like waves were observed with spatiotemporal evolution. Five minutes after starting phenytoin, aphasia started to improve, which completely disappeared 15 minutes after starting phenytoin.
Figure 2.
Figure 2.. Positive spike frequency histogram.
Frequency histogram analysis of positive electroencephalographic spikes in an 18-year-old woman with recurrent, prolonged, post-hyperventilation apnea. Positive spikes were marked, in particular, during hyperventilation, which was interpreted as autonomic epileptic seizures. Quoted from Nagayama .
Figure 3.
Figure 3.. Hypersexuality in Klüver–Bucy syndrome before/after intravenous phenytoin.
Changes in overeating and sexual behaviors in a 65-year-old male patient with nonconvulsive status epilepticus manifesting as Klüver–Bucy syndrome. Hypersexuality decreased immediately after the initiation of phenytoin therapy and completely disappeared two weeks later. Overeating also disappeared but was followed by severe anorexia.
See this image and copyright information in PMC

References

    1. Kaplan PW: Assessing the outcomes in patients with nonconvulsive status epilepticus: nonconvulsive status epilepticus is underdiagnosed, potentially overtreated, and confounded by comorbidity. J Clin Neurophysiol. 1999;16(4):341–52. 10.1097/00004691-199907000-00006 - DOI - PubMed
    1. Kaplan PW: Nonconvulsive status epilepticus in the emergency room. Epilepsia. 1996;37(7):643–50. 10.1111/j.1528-1157.1996.tb00628.x - DOI - PubMed
    1. Brophy GM, Bell R, Claassen J, et al. : Neurocritical Care Society Status Epilepticus Guideline Writing Committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3–23. 10.1007/s12028-012-9695-z - DOI - PubMed

    2. F1000 Recommendation

    1. Trinka E, Cock H, Hesdorffer D, et al. : A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015;56(10):1515–23. 10.1111/epi.13121 - DOI - PubMed

    2. F1000 Recommendation

    1. Bleck TP, Smith MC, Pierre-Louis SJ, et al. : Neurologic complications of critical medical illnesses. Crit Care Med. 1993;21(1):98–103. - PubMed

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