Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea
ABSTRACT
Nonconvulsive status epilepticus (NCSE) is a state of ongoing seizure activity for at least 30 minutes, with cognitive or behavioral changes, but without convulsive clinical manifestations. NCSE is usually underdiagnosed and a complicated heterogeneous syndrome. It requires EEG for diagnosis. The correct diagnosis, treatment, and prognostication of the NCSE rely on a high index of suspicion, careful clinical observation, EEG interpretation, and categorization according to etiology and level of consciousness. NCSE is a medical emergency and associated with substantial mortality, which is associated with an acute medical cause as the underlying etiology, severe mental status impairment, and development of acute complication. A major challenge is to help establish optimal treatment for particular patients with NCSE, tailored accurately to categorized types of NCSE, urgency, and morbidity. Prolonged prospective studies are required to determine the natural history of NCSE and which patients will benefit from aggressive treatment.