Non-convulsive status epilepticus

Abstract

Tonic-clonic status epilepticus is defined as tonic-clonic epileptic seizure which persists for more than 30 minutes or is repeated for more than 30 minutes without the patient gaining consciousness. It is not a problem to diagnose convulsive status epilepticus. In general all types of epileptic seizures (sensitive and senzoric simplex partial seizures, complex partial seizures, absency, seizures of apnoe, etc.) can be prolonged, can persist for minutes, hours and also for several days. At first sight these epileptic statuses may not be recognised as epileptic ones. According to Kaplan, the clinical characteristics of non-convulsive status epilepticus are sudden behavioral or cognitive changes which differ from the previous state and persist for longer than 30 minutes with epileptic (paroxysmal) signs on the EEG. These symptoms are often diagnosed as psychogenic and patients are not hospitalised in neurologic departments, but very often in psychiatric or general medicine departments. These symptoms are very often misdiagnosed, they are not adequately treated and it is very important to know that they can be combined with symptoms of other diseases. The diagnosis in these cases can be confirmed only by EEG. Four cases of non-convulsive status epilepticus are reported in this work.