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| The clinical and EEG features of 9 cases of patients with nonconvulsive status epilepticus |
| ZHANG Min1 MA Xu1 YANG Chunxiao1 HOU Xiaohua2 BIAN Yi2 LIU Hui2 YAO Lifen2 |
1.Department of Neurology, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang Province, Harbin 150086, China;
2.Department of Neurology, the First Affiliated Hospital of Harbin Medical University, Heilongjiang Province, Harbin 150001, China |
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Abstract Objective To investigate the clinical and EEG features of 9 cases of nonconvulsive status epilepticus (NCSE) with the purpose of increasing cognition of the disease and avoiding missed diagnosis. Methods Nine cases diagnosed or highly suspected of NCSE from the First Affiliated Hospital of Harbin Medical University and the Second Affiliated Hospital of Harbin Medical University from June 2013 to June 2017 were selected, their etiological, clinical manifestations, EEG features and prognosis were analyzed. Results Among 9 NCSE patients, there were 5 cases with acute etiological factors, 2 cases with chronic etiological factors and 2 cases without any special disease. Four patients′cognitive ability was assessed by the mini-mental state examination (MMSE) scale at the stage of attack and cognitive disorder was found, 5 patients can't cooperate with the test. Three patients′ grades were improved after treatment, one was in line with before. All 9 patients presented EEG abnormal with multiple patterns, 7 cases with epileptic discharge, one with slow waves background and rhythmic delta waves discharge, one with EEG background break up accompany slow-wave gave out. Five cases′ seizure remitted after treatment, one case still had a seizure, one with the illness worsened, two cases were dead. Conclusion The etiological, clinical and EEG of NCSE are complex. Increasing cognition of the disease and giving EEG test timely is vital for diagnosis. The prognosis is in line with the etiological, patients with curable etiological factors of NCSE may have an ideal prognosis.
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[1] Trinka E，Cock H，Hesdorffer D，et al. A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus [J]. Epilepsia，2015，56（10）：1515-1523.
[2] Beniczky S，Hirsch LJ，Kaplan PW，et al. Unified EEG terminology and criteria for nonconvulsive status epilepticus [J]. Epilepsia，2013，54（Suppl 6）：28-29.
[3] 温洪波，张振馨，牛富生，等.北京地区蒙特利尔认知量表的应用研究[J].中华内科杂志，2008，47（1）：36-39.
[4] Mnatsakanyan L，Chung JM，Tsimerinov EI，et al. Intravenous Lacosamide in refractory nonconvulsive status epilepticus [J]. Seizure，2012，21（3）：198-201.
[5] Dunne JW，Summers QA，Stewart-Wynne EG. Non-convulsive status epilepticus：a prospective study in an adult general hospital [J]. Q J Med，1987，62（238）：117-126.
[6] Rudin D，Grize L，Schindler C，et al. High prevalence of nonconvulsive and subtle status epilepticus in an ICU of a tertiary care center：a three-year observational cohort study [J]. Epilepsy Res，2011，96（1/2）：140-150.
[7] Laccheo I，Sonmezturk H，Bhatt AB，et al. Non-convulsive status epilepticus and non-convulsive seizures in neurological ICU patients [J]. Neurocrit Care，2015，22（2）：202-211.
[8] Mizobuchi M. Nonconvulsive Status Epilepticus [J]. Brain Nerve，2016，64（4）：451-462.
[9] Gosavi TD，See SJ，Lim SH. Ictal and interictal EEG patterns in patients with nonconvulsive and subtle convulsive status epilepticus [J]. Epilepsy Behav，2015，49（2）：63-67.
[10] Rossetti AO，Oddo M，Liaudet L，et al. Predictors of awakening from postanoxic status epilepticus after therapeutic hypothermia [J]. Neurology，2009，72（8）：744-749.
[11] Fernandez-Torre JL，Kaplan PW，Hernandez-Hernandez MA. New understanding of nonconvulsive status epilepticus in adults：treatments and challenges [J]. Expert Rev Neurother，2015，15（12）：1455-1473.
[12] Kaplan PW. Nonconvulsive status epilepticus [J]. Semin Neurol，1996，16（1）：33-40.
[13] Chanson E，Bicilli E，Lauxerois M，et al. Anti-NMDA-R encephalitis：Should we consider extreme delta brush as electrical status epilepticus? [J]. Neurophysiol Clin，2016， 46（1）：17-25.
[14] 汪芳，邵良，黄怀宇，等.表现为非惊厥性癫痫持续状态的边缘叶脑炎的临床和脑电图特征[J].临床神经病学杂志，2016，29（4）：259-262.
[15] Kaplan PW. The clinical features，diagnosis，and prognosis of nonconvulsive statusepilepticus [J]. Neurologist，2005， 11（6）：348-361.
[16] Maganti R，Gerber P，Drees C，et al. Nonconvulsive status epilepticus [J]. Epilepsy Behav，2008，12（4）：572-586.
[17] Kinney MO，Kaplan PW. An update on the recognition and treatment of non-convulsive status epilepticus in the intensive care unit [J]. Expert Rev Neurother，2017，17（10）：987-1002.
[18] Treiman DM，Meyers PD，Walton NY，et al. A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group [J]. N Engl J Med，1998，339（12）：792-798.
[19] Tu TM，Loh NK，Tan NC. Clinical risk factors for non-convulsive status epilepticus during emergent electroencephalogram [J]. Seizure，2013，22（9）：794-797.
[20] 刘晓燕.临床脑电图学[M].2版.北京：人民卫生出版社，2017：301-302.
[21] Casciato S，Morano A，Fattouch J，et al. Ictal pain in focal non-convulsive status epilepticus [J]. Pract Neurol，2017，17（5）：400-402. |
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