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The yield of routine electroencephalography in the detection of incidental nonconvulsive status epilepticus--a prospective study.
Clin Neurophysiol. 2012 Mar; 123(3):459-62.CN

Abstract

OBJECTIVE

Diagnosis of NCSE is challenging, because the clinical presentation ranges from minimally altered mental status to coma without tonic-clonic activity. According to the largest retrospective study to date the incidence of NCSE is about 0.2%.

METHODS

We prospectively investigated electroencephalography (EEG) recordings of 2514 consecutive patients that were referred to the Electrophysiology Unit of Department of Neurology, Vienna General Hospital between November 2009 and February 2011 (i.e. 16months).

RESULTS

The incidence of NCSE in our study population was 0.8%, i.e. the EEG of 19 patients fulfilled the criteria of NCSE. In 53% of these patients the NCSE was not suspected by treating physicians. A severely reduced level of consciousness was found in 78% of patients with a suspected NCSE and in 30% of patients with an unsuspected NCSE, although the results were not statistically significant (p=0.081). The delay between the admission to the hospital and diagnosis ranged between 0 and 51days.

CONCLUSIONS

NCSE was an unsuspected finding in more than half of the patients. Consciousness was severely impaired in only one third of these patients.

SIGNIFICANCE

These results highlight the importance of urgent EEG for the diagnosis of NCSE in patients even without significant impairment of consciousness.

Authors+Show Affiliations

Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. stefan.seidel@meduniwien.ac.atNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21775201

Citation

Seidel, Stefan, et al. "The Yield of Routine Electroencephalography in the Detection of Incidental Nonconvulsive Status Epilepticus--a Prospective Study." Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, vol. 123, no. 3, 2012, pp. 459-62.
Seidel S, Aull-Watschinger S, Pataraia E. The yield of routine electroencephalography in the detection of incidental nonconvulsive status epilepticus--a prospective study. Clin Neurophysiol. 2012;123(3):459-62.
Seidel, S., Aull-Watschinger, S., & Pataraia, E. (2012). The yield of routine electroencephalography in the detection of incidental nonconvulsive status epilepticus--a prospective study. Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology, 123(3), 459-62. https://doi.org/10.1016/j.clinph.2011.06.025
Seidel S, Aull-Watschinger S, Pataraia E. The Yield of Routine Electroencephalography in the Detection of Incidental Nonconvulsive Status Epilepticus--a Prospective Study. Clin Neurophysiol. 2012;123(3):459-62. PubMed PMID: 21775201.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The yield of routine electroencephalography in the detection of incidental nonconvulsive status epilepticus--a prospective study. AU - Seidel,Stefan, AU - Aull-Watschinger,Susanne, AU - Pataraia,Ekaterina, Y1 - 2011/07/19/ PY - 2011/04/06/received PY - 2011/06/11/revised PY - 2011/06/27/accepted PY - 2011/7/22/entrez PY - 2011/7/22/pubmed PY - 2012/3/27/medline SP - 459 EP - 62 JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology JO - Clin Neurophysiol VL - 123 IS - 3 N2 - OBJECTIVE: Diagnosis of NCSE is challenging, because the clinical presentation ranges from minimally altered mental status to coma without tonic-clonic activity. According to the largest retrospective study to date the incidence of NCSE is about 0.2%. METHODS: We prospectively investigated electroencephalography (EEG) recordings of 2514 consecutive patients that were referred to the Electrophysiology Unit of Department of Neurology, Vienna General Hospital between November 2009 and February 2011 (i.e. 16months). RESULTS: The incidence of NCSE in our study population was 0.8%, i.e. the EEG of 19 patients fulfilled the criteria of NCSE. In 53% of these patients the NCSE was not suspected by treating physicians. A severely reduced level of consciousness was found in 78% of patients with a suspected NCSE and in 30% of patients with an unsuspected NCSE, although the results were not statistically significant (p=0.081). The delay between the admission to the hospital and diagnosis ranged between 0 and 51days. CONCLUSIONS: NCSE was an unsuspected finding in more than half of the patients. Consciousness was severely impaired in only one third of these patients. SIGNIFICANCE: These results highlight the importance of urgent EEG for the diagnosis of NCSE in patients even without significant impairment of consciousness. SN - 1872-8952 UR - https://www.unboundmedicine.com/medline/citation/21775201/The_yield_of_routine_electroencephalography_in_the_detection_of_incidental_nonconvulsive_status_epilepticus__a_prospective_study_ DB - PRIME DP - Unbound Medicine ER -