Nonconvulsive Status Epilepticus: Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico

Area of Science:

• Neurology
• Epileptology
• Clinical Neuroscience

Background:

• Nonconvulsive status epilepticus (NCSE) is understudied in developing countries, despite Mexico having the highest epilepsy prevalence in the Americas.
• Limited clinical and epidemiological data exist regarding NCSE in this region.

Purpose of the Study:

• To characterize the clinical presentation, electroencephalogram (EEG) findings, and outcomes of NCSE patients in a Mexican tertiary care center.
• To identify factors influencing NCSE prognosis in a developing country context.

Main Methods:

• Retrospective case series of 134 patients (≥15 years) diagnosed with NCSE between 2010-2020.
• Data collection included demographics, epilepsy history, clinical manifestations, triggers, etiology, EEG patterns, and treatment outcomes.
• Statistical analysis involved descriptive statistics and multinomial logistic regression.

Main Results:

• The cohort (54.8% female, mean age 39.5 years) predominantly had a history of epilepsy (71%).
• Altered consciousness (82%) and coma (27.7%) were common; generalized NCSE patterns were most frequent (32.1%).
• Idiopathic etiology (56%) and uncontrolled epilepsy (48%) were primary triggers; 54.5% achieved remission with improvement.

Conclusions:

• Factors negatively impacting NCSE prognosis include older age, history of perinatal hypoxia, coma, and focal ictal EEG patterns.
• Absence of generalized EEG slowing was associated with a significantly better prognosis.
• Findings highlight key prognostic indicators for NCSE management in resource-limited settings.