ABSTRACT

Objectives:

We evaluated patients with nonconvulsive status epilepticus (NCSE) with regard to etiology, diagnosis, treatment, and prognosis.

Patients and Methods:

The study included five patients (4 females, 1 male; mean age 59 years; range 44 to 84 years) who had no previous history of seizures and antiepileptic drug use. Diagnosis of NCSE was first suspected by changes in behavior and/or consciousneş and then made by electroencephalography examination and following response to intravenous antiepileptic treatment.

Results:

Development of NCSE was attributed to cefepime treatment, decompensated liver insuff i c i e ncy and sepsis, dural infiltration secondary to non- Hodgkin lymphoma, and electroconvulsive treatment in four patients, respectively. In one patient, the etiology could not be determined. Improvement was obtained in five patients following intravenous antiepileptic treatment, in one of whom cefepime was discontinued. No recurrences were detected in two patients. One patient who experienced rare complex partial seizures was maintained on oral antiepileptic drug therapy. One patient died from severe systemic problems after two days, and another from non- Hodgkin lymphoma seven months later.

Conclusion: Nonconvulsive status epilepticus may occur due to many causes. Clinical features and EEG findings should be incorporated into an etiologic diagnosis. Where EEG is not available, clinical response to intravenous antiepileptic treatment may provide the diagnosis.