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Chapter 9 - Nonconvulsive Status Epilepticus (NCSE)

from Part II - Case-Based Approach to Specific Conditions

Published online by Cambridge University Press:  22 February 2024

Neville M. Jadeja  and
Kyle C. Rossi
Neville M. Jadeja
Affiliation:
University of Massachusetts Medical School
Kyle C. Rossi
Affiliation:
University of Massachusetts Medical School
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Summary

This chapter describes the diagnosis, types, and management of nonconvulsive status epilepticus using a case-based approach. Generalized status epilepticus including nonconvulsive status epilepticus (NCSE) is a medical emergency that is best managed in an intensive care unit with continuous EEG monitoring. Refractory status epilepticus (RSE) is defined as the failure of seizure activity to terminate despite initial benzodiazepines and additional intravenous antiseizure medications. Refractory status epilepticus is an indication for intravenous anesthetics such as midazolam and propofol with the goal of titrating to burst suppression. Highly epileptiform bursts seen are associated with status epilepticus recurrence despite treatment with intravenous anesthetics, a condition known as super-refractory status epilepticus (SRSE). Additionally, this chapter also describes how to recognize status epilepticus cessation and an uncommon form of NCSE called absence status epilepticus.

Keywords

nonconvulsive status epilepticusrefractory status epilepticusburst suppresssionsuper-refractory status epilepticusstatus epilepticus cessationabsence statusde novo absence status
Type
Chapter
Information
Critical Care EEG Basics
Rapid Bedside EEG Reading for Acute Care Providers
 , pp. 123 - 143
Publisher: Cambridge University Press
Print publication year: 2024

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References

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