Non-convulsive status epilepticus: mimics and chameleons

Area of Science:

• Neurology
• Epileptology

Background:

• Non-convulsive status epilepticus (NCSE) presents with diverse symptoms and is frequently misdiagnosed.
• Delayed diagnosis of NCSE can lead to significant neurological damage.

Observation:

• Failure to order electroencephalograms (EEGs) is a primary reason for delayed NCSE diagnosis.
• Some NCSE cases lack typical EEG findings, complicating diagnosis.

Findings:

• In resource-limited settings, especially during off-hours, empirical treatment for suspected NCSE may be necessary without EEG confirmation.
• A thorough risk-benefit assessment is crucial when deciding on therapeutic interventions for NCSE.

Implications:

• This approach aims to mitigate neuronal injury while minimizing treatment-related adverse effects.
• Collaboration with EEG, intensive care, and epilepsy specialists is vital for optimal NCSE patient management.