Diagnosis, Clinical Features And Refractoriness To Treatment In Nonconvulsive Status Epilepticus

Objectives: The aim of the study was to analyze the etiology, treatment and clinical and electroencephalographic features in adult patients with nonconvulsive status epilepticus (NCSE).Methods: We retrospectively evaluated all consecutive patients with NCSE admitted to our hospital between 2006 and 2010. Patient data and diagnostic test results were recorded. The following treatment protocol was used: 1) Diazepam 10 mg, 2) Phenytoin (18 mg/kg), 3) Midazolam (0.1-0.6 mg/kg/h), and 4) Thiopental (3-5 mg/kg/h) i. v. infusion. The groups were structured according to the necessity of treatment. Group 1 (n: 31): NCSE was treated with diazepam and phenytoin; and Group 2 (n: 7): NCSE was treated with midazolam or thiopental. Group 2 was also defined as refractory status epilepticus (RSE).Results: We studied 38 episodes in 35 adults (16 men, 19 women; median age: 61.8 years). Of the patients, 84.2% had a history of epilepsy, 44.7% had structural disorders, 13.2% had metabolic disorders, 18.4% had systemic infections, 15.8% had encephalitis, and 5.3% had antiepileptic drug withdrawal. In patients, 65.8% of them exhibited focal and 34.2% exhibited generalized status epilepticus discharges on EEGs. RSE occurred in approximately 18% of patients and was not associated with etiology, history of epilepsy, and clinical or electroencephalographic features.Conclusion: The majority of our patients had a history of epilepsy. Of the patients, 18% had RSE. There was no significant correlation among the treatment groups with respect to etiology, history of epilepsy, and clinical or electroencephalographic features.