ABSTRACT
Nonconvulsive status epilepticus (NCSE) is difficult to diagnose but is an important cause of cognitive impairment. Electroencephalogram (EEG) monitoring is required for diagnosis and treatment. Little is known regarding the stability of subclinical epileptiform discharges (SEDs) preceding NCSE nor what strategies may optimize patient outcomes. We report extended follow-up of patients with recurrent frontal SEDs, integrating EEG and cognitive findings before and following treatment of NCSE, and show that quantitating SED severity provides an objective marker of treatment efficacy and recurrence.
Subject(s)
Epilepsy, Frontal Lobe/diagnosis , Status Epilepticus/diagnosis , Aged , Electroencephalography , Epilepsy, Frontal Lobe/complications , Epilepsy, Frontal Lobe/drug therapy , Follow-Up Studies , Humans , Middle Aged , Outcome Assessment, Health Care , Recurrence , Retrospective Studies , Risk Factors , Status Epilepticus/complications , Status Epilepticus/drug therapy , Treatment OutcomeABSTRACT
BACKGROUND: Status epilepticus is a rare but potentially life threatening complication that women with epilepsy may experience during pregnancy. Poor compliance may contribute to the occurrence of status epilepticus, resulting in the need for substantial increases in anticonvulsant dosing to suppress seizures. CASE: A 39-year-old woman, gravida 2, para 0, abortion 1, with a history of epilepsy since childhood, delivered twins following an episode of myoclonic status epilepticus. The infants tolerated the maternal seizures and the aggressive anticonvulsant therapy without residual problems. CONCLUSION: Status epilepticus seems more likely to occur in women with epilepsy during the third trimester. Fourteen of 19, or 74%, of cases reviewed, including the case we report on here, experienced status epilepticus in the third trimester or during labor.
