Nonconvulsive status epilepticus in the emergency room
Nonconvulsive status epilepticus in the emergency room
复制标题
DOI：
10.1111/j.1528-1157.1996.tb00628.x
复制
发表时间：
1996-07-01
期刊：
影响因子：
5.6
通讯作者：
Kaplan, PW
中科院分区：
文献类型：
--
作者：
Kaplan, PW
目的：本研究回顾了非惊厥性癫痫持续状态（NCSE）的紧急情况下，以评估诊断和管理延迟的原因，并检查频繁的诊断功能提示NCSE.Methods：在一项回顾性研究中，我们评估了23例患者的临床表现与一个或多个NCSE发作，他们的病史，脑电图，抗癫痫药物（AED）治疗。我们还评估了诊断延迟的原因，在混乱state.Results的急诊室（ER）的病人提到：有相当大的重叠，复杂的部分SE（CPSE）和全身性非惊厥性SE（GNSE）的患者的临床特征。延误就医的情况很常见。10例患者的诊断明显延迟。三例说明可能显着不同的presentation NCSE.Conclusions：NCSE往往不被承认或被误认为是行为或精神障碍。NCSE的多形性临床表现表明，脑电图和抗癫痫药物的治疗试验提供了最好的诊断措施，在急性盈亏混乱状态与激动，奇怪的行为，凝视，音调增加，缄默症，或微妙的肌阵挛。
Purpose: The study reviewed emergent cases of nonconvulsive status epilepticus (NCSE) to evaluate causes of diagnostic and management delay and examined frequent diagnostic features suggestive of NCSE.Methods: In a retrospective study, we assessed the clinical presentation of 23 patients with one or more NCSE episodes, their medical history, EEG, and antiepileptic drug (AED) treatment. We also evaluated causes of diagnostic delay in patients referred to the emergency room (ER) in confusional states.Results: There was considerable overlap in clinical features of patients with complex partial SE (CPSE) and generalized nonconvulsive SE (GNSE). Delays in seeking medical attention were common. Diagnosis was significantly delayed in 10 patients. Three cases illustrate the possible markedly different presentations of NCSE.Conclusions: NCSE often goes unrecognized or is mistaken for behavioral or psychiatric disturbance. The pleomorphic clinical presentation of NCSE indicates that EEG and a therapeutic trial of AEDs afford the best diagnostic measures in acute waxing and waning confusional states associated with agitation, bizarre behavior, staring, increased tone, mutism, or subtle myoclonus.