Nonconvulsive status epilepticus (NCSE) is defined as a condition causing mental status or behavioral changes clinically, which are associated with continuous ictal activity on electroencephalography (EEG) in the absence of convulsive seizures. Delay in the diagnosis of NCSE may increase morbidity and mortality. Several EEG patterns have been identified in NCSE. Triphasic waves accepted as pathognomonic for hepatic encephalopathy are also seen in NCSE. In this presentation, we discuss a differential diagnosis of metabolic encephalopathy and NCSE with the help of a case thought to be NCSE clinically and associated with continuous triphasic waves in EEG.

Keywords: metabolic encephalopathy, nonconvulsive status epilepticus, triphasic waves