Neurológia pre prax 3/2024

Nonconvulsive status epilepticus

Non-convulsive status epilepticus (NCSE) is an important cause of morbidity and mortality, especially in patients with acute cerebral insults and those in need of neurointensive care. NCSE is a clinically heterogeneous group of conditions and the clinical manifestations, EEG findings, treatment and prognosis vary widely according to the clinical context in which NCSE occurs (age, presence of epilepsy, comorbidities, comedication, presence of an acute structural brain lesion or acute systemic disorder). EEG is essential for the diagnosis of NCSE. However, especially in patients with acute symptomatic NCSE, a wide variety of EEG findings occur that do not allow to determine with certainty whether they are caused by the epileptic activity itself or by the causative lesion – the so-called ictal-interictal continuum. Treatment of NCSE can be challenging and requires close collaboration between clinicians and EEG-readers. Critical is the early identification of NCSE and underlying etiology and properly managed treatment.

Keywords: status epilepticus, non‑convulsive status epilepticus, seizures, electroencephalography