Non-convulsive status epilepticus; the rate of occurrence in a general hospital

被引:43
作者
Alroughani, R.
Javidan, M.
Qasem, A.
Alotaibi, N.
机构
[1] Univ British Columbia, Dept Neurophysiol, Vancouver, BC V5Z 1M9, Canada
[2] Univ British Columbia, Div Neurol, Vancouver Gen Hosp, Epilepsy Program, Vancouver, BC V5Z 1M9, Canada
来源
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY | 2009年 / 18卷 / 01期
关键词
Non-convulsive status epilepticus; Continuous EEG monitoring; Hypoxic-anoxic brain injury; Young's criteria; SUSTAINING STATUS EPILEPTICUS; CLINICAL-FEATURES; COMATOSE PATIENTS; ABSENCE-STATUS; SEIZURES; PREVALENCE; PROGNOSIS; MORTALITY; DAMAGE; BRAIN;
D O I
10.1016/j.seizure.2008.06.013
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Non-convulsive status epilepticus (NCSE) has been increasingly recognized as a cause of impaired level of consciousness in the ICU and emergency rooms. The diagnosis can be easily missed without an electroencephalogram (EEG) given the paucity of overt clinical signs in this condition. Recently few published data estimated the prevalence to be between 3% and 8%. Objective: To assess the rate of occurrence of NCSE among patients with various degrees of impaired consciousness referred to the Neurophysiology Laboratory at Vancouver General Hospital. Method: We conducted a retrospective analysis of 451 adult patients(>16 years of age) with a question of NCSE or with an unknown cause of impaired level of consciousness between the years 2002 and 2004. NCSE was defined according to the Young's criteria of electrographic status epilepticus. NCSE was categorized into focal and generalized epileptic activity based on the continuous EEG monitoring (CEEG). Further analysis of age, gender and etiology was performed. Results: Of 451 patients, EEG demonstrated electrographic status epilepticus with no overt clinical signs in 42 patients (9.3%). Median age was 61.8 years (range 21-94). According to etiology, 38.1% of patients with NCSE had hypoxic-anoxic injury, 19% had intracerebral hemorrhage (including trauma), 11.9% had the diagnosis of idiopathic or cryptogenic epilepsy, 7.1% had ischemic stroke, 4.8% were secondary to tumors and 4.8% to viral encephalitis. Conclusion: The rate Of Occurrence of NCSE in patients with decreased level of consciousness was 9.3%. The cohort represented a group of patients who were comatose and required assisted ventilation or had altered level of consciousness. Hypoxic brain injury was the most responsible etiology of NCSE in the cohort studied. (C) 2008 Published by Elsevier Ltd on behalf of British Epilepsy Association.
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收藏
页码:38 / 42
页数:5
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