S1-3. Consideration of consciousness in terms of NCSE: From psychiatrists’ point of view

Abstract

Diagnosis and treatment of status epilepticus is needed when we see patients with epilepsy. International League Against Epilepsy (ILAE) proposed a new definition of status epilepticus in 2015. Status epilepticus is categorized as convulsive or nonconvulsive. Non-convulsive status epilepticus (NCSE) includes various type of clinical manifestations with different level of disturbance of consciousness. When we carefully observe patients with NCSE, we need to consider “consciousness”. A new definition of epileptic seizures which was proposed by ILAE in 2017 uses a term “awareness” instead of “consciousness” which was used in a traditional definition. Consideration of consciousness is one of the important topics in epileptology. EEG is essential for diagnosis of epilepsy and seizures. Recently, simultaneous recording of EEG and functional MRI has applied to patient with epilepsy. EEG-fMRI studies revealed that epileptogenic region and surrounding areas were activated at the time of epileptic activities. At the same time, specific brain regions called Default Mode Network (DMN) which were activated in a resting state in healthy subjects were deactivated in the patients. DMN deactivation might be helpful to understand consciousness of NCSE. In this lecture, I will present some videos of NCSE and consider consciousness in terms of epileptology and clinical neurophysiology.