In this post, I link to and excerpt from Emergency Medicine Cases‘ Best Case Ever 22: Nonconvulsive Status Epilepticus (NCSE).
Published by Anton Helman, May 2014
All that follows is from the above resource.
Pearls on Nonconvulsive Status Epilepticus
- Think about nonconvulsive status epilepticus in patients who have had seizures with prolonged post ictal phases or no cause found for their decreased level of awareness
- For patients whom you have ruled out all the usual causes of decreased level of awareness, try administering a dose of midazolam – if the patient’s level of awareness improves, the diagnosis is likely nonconvulsive status epilepticus
- Most patients with nonconvulsive status epilepticus will have very subtle abnormal eye (eg: blinking), face (eg: grimacing) or limb motor activity – take your time to look for these movements in your patients who are found down
For a great review of nonconvulsive status epilepticus go to the Life in the Fast Lane blog.
For more on the ‘found down’ patient and nonconvulsive status epilepticus with Dr. Carr and Dr. Brian Steinhart listen to Episode 13
