Abstracts

Abstract

Abstract B. Aktekin , A. Unal , B. Ekmekci Usta , and A. Aralasmak Department of Neurology, Akdeniz University Medical Faculty, Antalya, TurkeyE-mail berrina@akdeniz.edu.tr Background: In recent years, many authors have preferred a revision of the strict definition of status epilepticus (SE) and proposed that any seizure exceeding 5–10 min should be considered as SE. SE is typically classified convulsive and nonconvulsive, based on if rhythmic jerking of the extremities is observed or not. However, further classification of nonconvulsive status epilepticus (NCSE) is still a matter of discussion. NCSE consists of very different syndromes, the diagnosis is difficult and requires electroencephalographic (EEG) confirmation, there is no widely accepted classification and epidemiologic, therapeutic and prognostic studies are lacking. Purpose: To describe electroclinical spectrum of elderly patients with NCSE who underwent video-EEG monitoring for diagnostic purposes. Method: Prospective case series studies of eight representative elderly NCSE patients (aged 69–77 year). Results: All patients had shown electroclinical SE pattern on video-EEG recordings. None of them had been given i.v. benzodiazepines because of concomitant systemic diseases. In the follow-up period, two out of eight patients developed mesial temporal sclerosis, one patient passed away, three patients had shown complete recovery with total seizure freedom with proper antiepileptic medication, and two of them needed additional antiepileptic drugs for complete seizure control. Conclusion: NCSE can occur at any age and the clinical features may vary widely. In our group, almost all of them had different underlying etiologies and needed different treatment regimens and different prognosis. The EEG is very useful tool for diagnosis and helps to evaluate brain dysfunction in acute waxing and waning confusional states associated with agitation, bizarre behavior, staring, mutism, or subtle myoclonus. The prognosis of NCSE is usually depends on the underlying etiology rather than the type of EEG discharges or seizure types. NCSE is an underdiagnosed medical emergency. In order to make correct diagnosis and treatment, high level of suspicion is necessary.