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From the Department of Neurology (Drs. Krumholz, Sung, Barry, Bergey, and Grattan), the University of Maryland School of Medicine, Baltimore, MD; and the Department of Neurology (Dr. Fisher), the Barrow Neurologic Institute, Phoenix, AZ.
Received August 23, 1994. Accepted in final form January 6, 1995.
Address correspondence and reprint requests to Dr. Allan Krumholz, Department of Neurology, University of Maryland Medical Center, Room N4W46, 22 South Greene Street, Baltimore, MD 21201.
Nonconvulsive status epilepticus (NCSE) accounts for approximately 20% of all status epilepticus (SE).Although convulsive SE is recognized as a medical emergency, prompt diagnosis and treatment of patients with NCSE is often not emphasized because its consequences are thought to be benign. We report 10 patients with persistent neurologic deficits or death after well-documented NCSE in the form of complex partial status epilepticus (CPSE). All patients had prolonged CPSE lasting 36 hours or longer, as documented by clinical and EEG findings. Causes for CPSE were preexisting epilepsy with partial and secondarily generalized seizures (3 patients), vascular disease (2 patients), encephalitis (2 patients), and metabolic disease (1 patient); causes were unknown for two patients. Poor outcomes identified included persistent (lasting at least 3 months) or permanent cognitive or memory loss (5 patients), cognitive or memory loss plus motor and sensory dysfunction (3 patients), and death (3 patients). NCSE in the form of CPSE is not a benign entity. Serious morbidity and mortality may occur due to the adverse effects of prolonged seizures and as a result of acute brain disorders that precipitate the seizures.
NEUROLOGY 1995;45: 1499-1504
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