Non-convulsive Status Epilepticus in Children: Clinical Profile, EEG Characteristics and Treatment

Non-convulsive status epilepticus (NCSE) is a term used to denote a range of conditions in which electrographic seizure activity is prolonged and results in non-convulsive clinical symptoms. This study was done to describe the clinical spectrum, EEG findings and to evaluate the efficacy of different therapeutic agents in children with NCSE in 33 patients from January 2011 to December 2015 period. All patients had EEG before and after treatment. Age range was 6 months to 14 year, 25 were male. Regarding development status, 48% had developmental delay, 21% had normal development, 9% had regression and 21% had both developmental delay and regression. Twenty nine cases were previously diagnosed as epilepsy. EEG diagnosis was as follows: Generalized NCSE 23(69%), focal 9(27%), unknown 1(3%). Eighteen patients were treated with Midazolam drip out of which 1 patient had complete remission in EEG, 6 had >80% remission, 5 had >50% remission and 5 patients had minimal or no response. Thirteen patients were treated with methyl prednisolone bolus out of which 2 patients had complete remission, 4 patients had >80% remission while 4 patients had >50% remission and 3 patients showed no response. NCSE may present with various clinical feature without any convulsion. Midazolam, methyl prednisolone and oral drugs are equally effective for treatment of NCSE. However, further randomized controlled study is needed to chalk out management of NCSE.