EEG in refractory status epilepticus

Abstract

EEG in refractory – and thus often long lasting and eventually subtle – status epilepticus is mostly characterized by generalized or lateralized periodic discharges. Based on EEG recordings alone, it is almost impossible to discern late forms of status epilepticus from various other severe nonepileptic encephalopathies. Periodic EEG patterns are not specific for circumscribed neurological conditions and are not pathognomonic for status epilepticus. Even disappearance of periodic discharges following administration of intravenous anticonvulsant does not prove the epileptic nature of specific EEG patterns. Generalized periodic discharges do not seem to be the cause and are not even a biological marker for poor prognosis. If the electro-clinical course allows making a definite diagnosis of refractory status epilepticus, EEG follow-up may help to tailor further therapeutic management.