Not all seizures include convulsions, neurologists explain, leading to diagnosis challenges and dangerous treatment delays
WASHINGTON, Jan. 18, 2024 /PRNewswire/ -- A lack of convulsions can make some extended seizures difficult to diagnose and treat, explains a new expert-led clinical proceedings paper from the Clinical Neurological Society of America. "Nonconvulsive Status Epilepticus: An Underrecognized Neurological Emergency" notes that, while convulsions are a clear sign of status epilepticus, not all seizures are accompanied by them.
The lack of clear motor symptoms makes it hard to identify NCSE during a clinical exam, delaying treatment and increasing the risk of morbidity and mortality. Adults with status epilepticus who do not experience convulsions have exponentially higher mortality rates than their peers who do experience convulsions, 27.6% vs. 3.5% respectively.
That's why EEGs – continuous if available, or at least rapid EEG for emergency monitoring – are essential to properly diagnose NCSE, the paper explains.
Authored by five neurologists, the paper calls for:
- better identification of nonconvulsive status epilepticus, or NCSE
- the use of electroencephalograms or EEGs for diagnosis, and
- timely treatment to stop seizures.
Paper Authors
- Gregory Kent Bergey, MD, FANA (clinical proceedings chair)
- Khalid Alsherbini, MD
- Angela N. Crudele, MD
- Shelly Rishty, MD
- Veeresh Kumar N. Shivamurthy, MD
About Nonconvulsive Status Epilepticus
Status epilepticus is a condition of prolonged seizures that can result in brain injury and death. An estimated 34% of all patients admitted to the hospital with first-ever status epilepticus due to non-hypoxic causes have NCSE. But in clinical practice, the condition is likely underdiagnosed and underrecognized.
STATEMENT FROM GREGORY BERGEY, MD, FANA, CHAIR FOR CLINICAL PROCEEDINGS, CLINICAL NEUROLOGICAL SOCIETY OF AMERICA: "Recognition of NCSE has already increased dramatically through use of continuous EEG and now, the potential of rapid EEG technologies can help, particularly centers that do not have ready access to cEEG. Early diagnosis and treatment of NCSE is important to optimize outcomes."
Learn more by reading "Nonconvulsive Status Epilepticus: An Underrecognized Neurological Emergency."
The Clinical Neurological Society of America, a non-profit 501(c)(6), is a nationwide organization of neurology clinicians with a mission to improve clinical practice and patient care through education.
SOURCE Clinical Neurological Society of America
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