Non-convulsive status epilepticus in comatose patients (case reports).

Non-convulsive status epilepticus (NCSE) is relatively rare, but recognized condition observed in non-epileptic comatose patients. In coma state NCSE may be precipitated by stroke, severe electrolyte disturbance, acute intoxication, infection, traumatic brain injury and etc. All these critical disorders can cause coma themselves and without clinical EEG investigation it is impossible to attribute impaired consciousness to NCSE, while the condition can be responsive to anticonvulsant medication. The proper and rapid diagnosis of NCSE is challenging, because it can severely impact the patient and often is a treatable and completely reversible state. Case reports describe the state of three comatose patients affected by severe neurological disorders, who were diagnosed as NCSE after EEG investigation. Nor of these patients were noted to have the epileptic seizures and convulsions. The patients were treated with different anticonvulsive medications (Finlepsin, Levetiracetam, Depakin) and fully recovered from coma state. Frequently, physicians could not suspect presence of NCSE in patients with impaired consciousness because of sufficiently complicated underlying illness. Apparently, clinical EEG investigation is useful to be performed in all comatose patients.