Abstract
BackgroundNonconvulsive status epilepticus (NCSE) is a severe medical condition and heterogeneous disorder defined by different seizure types and diverse etiologies. NCSE occurs commonly in the elderly and is potentially misdiagnosed as a psychiatric disorder. Current treatment options for NCSE are still unsatisfactory.Case presentationWe report a case of NCSE in a 55-year-old epileptic male patient with a history of infectious encephalitis, disinhibitory behavior, and a suspected diagnosis of frontotemporal dementia. Add-on levetiracetam (LEV) to carbamazepine treatment improved clinical manifestations and abnormal electroencephalographic discharge.ConclusionWith disinhibitory behavior in the elderly, the possibility of NCSE should be considered. Moreover, LEV may be an effective and well-tolerated pharmacotherapy for elderly NCSE patients.
Highlights
Nonconvulsive status epilepticus (NCSE) is common and often manifests as altered consciousness accompanied by subtle motor twitches or ambiguous behavior changes [1], there are subtypes of NCSE without altered consciousness
Type 1 is characterized by mood and behavior, either a hypomanic state related to right frontal focus with affective disinhibition and increased verbal fluency or a state of emotional indifference related to left frontal focus with diminished facial expression, reduced verbal fluency, and decreased emotion and spontaneous activity, without clear alteration of consciousness, and most patients are able to recall the episode
NCSE is a heterogeneous disorder including a number of subtypes with varied electroclinical feature manifestations
Summary
With disinhibitory behavior in the elderly, the possibility of NCSE should be considered.
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