Non-convulsive status epilepticus (NCSE) can be a challenging diagnosis to make. It is an important cause of unexplained coma.


Key features:

(1) seizure activity demonstrated on EEG

(2) episode lasting > 30 minutes (may be continuous or involve multiple episodes without full recovery between episodes)

(3) absence of major motor signs (dystonic posturing, orolingual automatisms, clonic movements)

(4) with or without minor motor signs (fluttering of eyelids, verbal automatisms, etc)


Clinical types:

(1) subtle (occurs after generalized convulsive status epilepticus)

(2) simple partial (alert during the episode but confused)

(3) complex partial (involves a twilight state with delirium, inappropriate responses, quasi-purposeful behaviors, etc)

(4) generalized (often comatose)


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