Non-convulsive Status Epilepticus and Non-Convulsive Seizures in Critically Ill Patients

Background: Non-convulsive seizures (NCS) or non-convulsive status epilepticus (NCSE) is a common problem in critically ill patients. They have been reported in 8–20 % of critically ill patient populations, and delayed diagnosis and treatment of NCSE may lead to increased mortality. Diagnosis of seizures in this particular population of patients can be challenging as clinical manifestations are often subtle or absent. On the other hand, delayed diagnosis and treatment of NCSE has been associated with higher patient morbidity and mortality. Methods: In this review, a general search in Medline, Science Direct and springer databases were done during years of 2010 to 2019. We evaluated human studies of NCS and NCSE in critically ill patients and the results are presented here in short. Findings: Identifying patients at higher risk of developing NCSE/NCS help prioritize cEEG monitoring when resources are limited. A past history of epilepsy, meningitis/encephalitis, CNS tumor, acute brain insults such as intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), and ischemic stroke are independent risk factor for developing NCSE/NCS. Conclusion: This review discusses specific clinical features along with history and potential risk factors to identify patients at high risk of NCSE/NCS in the critical care unit and highlights the therapeutic options for early management of NCSE/NCS.

Keywords:

Status Non-Convulsive Seizures , Non-Convulsive Status Epilepticus , Critically Care , Altered mental State , cEEG Monitoring