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Status non-epilepticus
Ronen Spierer1, Moshe Herskovitz1,2
1Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Objective:
Status non-epilepticus is characterized by recurrent or prolonged psychogenic non-epileptic seizures (PNES), which are often mistaken for status epilepticus (SE). This study focuses on the misdiagnosis of convulsive SE in patients whose seizures were of psychogenic origin.
Methods:
We analyzed 13 events of 8 patients initially misdiagnosed as having convulsive SE. The diagnostic evaluation included a review of their clinical presentation, treatment, and treatment response.
Results:
The patients in this study were predominantly treated with benzodiazepines (BZD). However, this treatment, together with anti-seizure medications (ASM) was mostly ineffective, leading to tracheal intubation in eight of the cases.
Significance:
When a convulsive event does not cease with BZD and ASM, we suggest considering a differential diagnosis of PNES. The poor response to BZD raises several hypotheses regarding the origin of PNES.
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