[Nonconvulsive status epilepticus in comatose adults].

INTRODUCTION

Nonconvulsive status epilepticus (SE) is a term used to denote a range of conditions in which electrographic seizure activity is prolonged and results in nonconvulsive clinical symptoms. Nowadays, some experts on nonconvulsive SE have emphasized the utility on the clinical practice to consider the classification taking in account both the clinical setting and the severity of consciousness impairment, differentiating between ambulatory patients (from almost normal mental state to stupor) which includes absence SE and complex partial SE; and nonconvulsive SE in coma.

AIM: To review the literature in relation to the diagnosis of nonconvulsive SE in comatose and/or critically ill patients.

DEVELOPMENT: Nonconvulsive SE has been reported with surprising frequency in a wide variety of acute neurological processes such as cerebrovascular disease, anoxia, subarachnoid hemorrhage, cranial trauma, encephalitis and following convulsive SE.

CONCLUSIONS

Nonconvulsive seizures and episodes of nonconvulsive SE in patients with severe impairment of consciousness are frequent and, therefore, continuous EEG monitoring is an essential neurophysiologic tool in the evaluation of comatose subjects. EEG interpretation in patients with nonconvulsive SE may be particularly difficult and problematic and, therefore, requires expert knowledge and a clinical and neurophysiologic specific training.