Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

Arquivos de Neuro-Psiquiatria

Paulo Breno Noronha Liberalesso¹  Eliana Garzon¹  Elza Marcia T. Yacubian¹  Américo C. Sakamoto¹ 

[1] ,Federal University of São Paulo Escola Paulista de Medicina Hospital São Paulo

关键词: nonconvulsive status epilepticus;    ictal patterns;    PLEDs;    estado de mal epiléptico não convulsivo;    padrões ictais;    PLEDs;   

DOI  :  10.1590/S0004-282X2012000700006

来源: SciELO

【 摘 要 】

OBJECTIVE: Nonconvulsive status epilepticus (NCSE) is currently considered as one of the most frequent types of status epilepticus (SE). The objective of the present study was to identify the natural history of the electrographical evolution of refractory NCSE and to establish the relationship between ictal patterns and prognosis. METHODS: We analyzed, retrospectively, 14 patients with loss of consciousness and NCSE. The ictal patterns were classified as discrete seizures (DS), merging seizures (MS), continuous ictal discharges (CID), continuous ictal discharges with flat periods (CID-F), and periodic lateralized epileptiform discharges (PLEDs). RESULTS: The ictal patterns were DS (n=7; 50.0%), PLEDs (n=3; 1.4%), CID (n=2; 14.3%), MS (n=1; 7.1%), and CID-F (n=1; 7.1%). CONCLUSIONS: NCSE electrographic findings are heterogeneous and do not follow a stereotyped sequence. PLEDs were related to a higher probability of neurological morbidity and mortality.

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