Nonconvulsive status epilepticus in the elderly: A case series and a review of the literature

Because of age related etiologies and complications, nonconvulsive status epilepticus (NCSE) may have a different prognosis in the elderly than in the young. We prospectively studied clinical characteristics and outcomes of 10 patients over age 65 years with NCSE. All underwent continuous videoelectroencephalogram monitoring. Patients' ages ranged between 65 and 95 years (mean = 80). Three patients had complex partial status epilepticus (CPSE), seven had complex partial and secondarily generalized NCSE, and none had primary generalized NCSE. Causes of NCSE were: stroke (four), metabolic derangement (two), brain neoplasia (one), head injury (one), electroconvulsive therapy (one), and preexisting epilepsy (one). One patient with hyponatremia and one patient with a previous seizure disorder recovered. Five patients were discharged with new neurologic deficits due to underlying processes; four of these patients also had infectious complications during hospitalization. Three patients died, all due to infectious complications. We conclude that NCSE in the elderly is associated with a poor prognosis, because of underlying causative processes and medical complications. (C) 1998 by Elsevier Science Inc. All rights reserved.