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July2014 Vol.51 Issue:        3       (Supp.) Table of Contents
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Value of Continuous EEG Monitoring, Emergent IV Benzodiazepines Administration in the Diagnosis of Nonconvulsive Status Epilepticus in Adults

Ehab Shaker1, Husam Salah1, Heba Raafat2

Departments of Neurology1, Clinical Neurophysiology Unit2, Cairo University; Egypt



ABSTRACT

Background: Nonconvulsive Status Epilepticus (NCSE) is much more common than generally appreciated. It is certainly underdiagnosed. NCSE may be one of the most frequently missed diagnoses in patients with altered neurologic function. The diagnosis of NCSE is important to make because NCSE impairs the patient’s health significantly and it is in most cases a treatable and completely reversible condition. Objective: The aim of the present study is to propose unified diagnostic criteria of NCSE in adults including a combination of three: Clinical suspicion, continuous EEG (cEEG) monitoring and emergent I.V benzodiazepines administration during cEEG monitoring. Methods: The study was conducted on 15 adult patients with pre-existing controlled epileptic syndrome and others with altered conscious level without any known cause. Thorough history taking, neurological examination, cEEG monitoring, and emergent IV benzodiazepines administration during cEEG were done to the patients. Results: Frequent and continuous generalized spike-and wave discharges were found in 46.66% of previously well-controlled epileptic patients, frequent and continuous focal discharges were found in 20% of previously known epileptic patients, frequent continuous generalized discharges without a prior history of epileptic syndrome were found in 13.33%, and periodic complexes were recorded in 20% of patients with coma. Upon emergent IV administration of Benzodiazepines during cEEG monitoring, all of them showed immediate EEG improvement and sometimes with clinical improvement (20%). Conclusion: This study concluded that cEEG monitoring and the simultaneous improvement of the cEEG criteria with or without clinical improvement after emergent IV administration of Benzodiazepines added unified diagnostic criteria of clinically suspected NCSE in adults. [Egypt J Neurol Psychiat Neurosurg.  2014; 51(3): 337-344]

Key Words:  NCSE; ICU; coma; cEEG; IV benzodiazepines.

Correspondence to Heba Raafat, Clinical Neurophysiology Unit, Faculty of Medicine, Cairo University; Egypt. Email: raafatheba@kasralainy.edu.eg

 






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