Abstract
Nonconvulsive status epilepticus (NCSE) encompasses a wide range of diagnoses with variable outcomes and treatment recommendations. In children, NCSE can be observed in various conditions, including acute neurological injuries, specific childhood epilepsy syndromes and other neurological conditions, and can also be observed in individuals with learning difficulties. NCSE in children is thought to be under-recognized, and further studies examining the electrographic characteristics of very young children in NCSE would aid the prompt recognition of additional patients. Some subtypes of NCSE are probably more harmful than others, and long-term prospective studies are needed to evaluate the damaging potential of NCSE itself as opposed to that of the underlying circumstances in which it occurs. Specific data in childhood are clearly lacking, but extrapolation from adult studies indicates that aggressive treatment is most warranted in comatose patients. By contrast, a cautious approach seems to be indicated for absence status epilepticus, complex partial status epilepticus and electrical status epilepticus during sleep.
Key Points
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Nonconvulsive status epilepticus (NCSE) has been defined as a cognitive or behavioral change that lasts for at least 30 minutes, with evidence of seizures on electroencephalogram
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The diagnosis of NCSE is difficult and requires a high index of suspicion; the condition is probably under-recognized
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The variation in the conditions encompassed by the term NCSE and the lack of agreement on diagnostic criteria, such as electroencephalographic features, contribute to its problematic identification
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NCSE is notoriously observed in various childhood epilepsy syndromes, encephalopathies and acute conditions
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Clear data regarding diagnosis, treatment and outcome of NCSE are particularly wanting in children
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Further studies analyzing the electroencephalographic features and clinical presentation of NCSE in children, especially the very young, are needed
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Korff, C., Nordli, D. Diagnosis and management of nonconvulsive status epilepticus in children. Nat Rev Neurol 3, 505–516 (2007). https://doi.org/10.1038/ncpneuro0605
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DOI: https://doi.org/10.1038/ncpneuro0605
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