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Neurocritical Care
Published in: Neurocritical Care 2/2015

01-04-2015 | Original Article

Non-convulsive Status Epilepticus and Non-convulsive Seizures in Neurological ICU Patients

Authors: Ikuko Laccheo, Hasan Sonmezturk, Amar B. Bhatt, Luke Tomycz, Yaping Shi, Marianna Ringel, Gina DiCarlo, DeAngelo Harris, John Barwise, Bassel Abou-Khalil, Kevin F. Haas

Published in: Neurocritical Care | Issue 2/2015

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Abstract

Background

Non-convulsive seizures (NCS) or non-convulsive status epilepticus (NCSE) has been reported in 8–20 % of critically ill patient populations, and delayed diagnosis and treatment of NCSE may lead to increased mortality. This study seeks to better understand the risk factors, characteristics, and outcome of NCS/NCSE in the neurological ICU.

Methods

This is a prospective observational study, recruiting consecutive patients admitted to the adult neurological ICU with altered mental status. Patients with anoxic brain injury were excluded from the study. Data were collected and analyzed for prevalence of NCSE/NCS, EEG patterns, associated risk factors, treatment response, and final outcome.

Results

NCSE/NCS was detected in 21 % of 170 subjects. Clinical seizures preceded EEG diagnosis of NCSE/NCS in 25 % of cases. Significant risk factors for NCSE/NCS were a past medical history of intracranial tumor, epilepsy, or meningitis/encephalitis, or MRI evidence of encephalomalacia. Subtle clinical findings such as twitching of oral or ocular muscles and eye deviations were found on exam in 50 % of the NCSE/NCS group. Mortality was increased in NCSE cases as 31 % of NCSE/NCS patients died compared to 14 % in non-NCSE/NCS group.

Conclusions

Specific clinical features along with history and imaging findings may be used to identify patients at high risk of NCSE/NCS in the neurological ICU.
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Metadata
Title
Non-convulsive Status Epilepticus and Non-convulsive Seizures in Neurological ICU Patients
Authors
Ikuko Laccheo
Hasan Sonmezturk
Amar B. Bhatt
Luke Tomycz
Yaping Shi
Marianna Ringel
Gina DiCarlo
DeAngelo Harris
John Barwise
Bassel Abou-Khalil
Kevin F. Haas
Publication date
01-04-2015
Publisher
Springer US
Published in
Neurocritical Care / Issue 2/2015
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-014-0070-0

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