[Concentration problem or epilepsy? Sudden changes in behaviour in adolescents]

Area of Science:

• Neurology
• Pediatrics
• Epileptology

Background:

• Non-convulsive status epilepticus (NCSE) is a generalized epilepsy form that can manifest as behavioral disturbances and cognitive impairment.
• This condition is frequently misdiagnosed due to its subtle presentation, lacking typical convulsive seizures.
• Behavioral changes and concentration problems in adolescents may indicate underlying NCSE.

Observation:

• This case series reports on three adolescent boys (13, 14, and 17 years old) who presented with behavioral disturbances attributed to idiopathic NCSE.
• Electroencephalography (EEG) confirmed the diagnosis of NCSE in all cases.
• One patient had a prior diagnosis of attention deficit hyperactivity disorder (ADHD), raising questions about the original diagnosis versus NCSE as the cause of his symptoms.

Findings:

• NCSE is characterized by diminished cognitive functioning in patients who otherwise appear reactive.
• Previous episodes of behavioral changes were noted in the medical history of all three patients.
• Cognitive function testing, particularly memory assessment, is essential for diagnosing NCSE.

Implications:

• Behavioral problems in children warrant a comprehensive neurological evaluation by a pediatrician or neurologist.
• Recognizing NCSE is critical to avoid misdiagnosis and ensure appropriate treatment.
• Early identification of NCSE can prevent potential long-term cognitive consequences and improve patient outcomes.