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You wonder: Is there something you forgot to consider in your differential diagnosis?Ī 35-year-old man with unknown history is brought to the ED following a 10-minute witnessed seizure.
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After an extensive workup in the ED including ECG, CBC, CMP, UA, and brain CT, all of which were normal, she was admitted to the floor. Her medications include furosemide, lorazepam, and acetaminophen. Her medical history is remarkable for anxiety, arthritis, and hypertension she has no history of stroke, trauma, or immunocompromise. On examination, she is disoriented, with no focal neurologic findings and no evidence of seizure activity. Case PresentationsĪn 81-year-old woman presents with 1 day of behavioral changes.
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The few established guidelines on the treatment of NCSE are highly variable, and the objective of this comprehensive review is to create a standardized evidence-based protocol for the diagnosis and treatment of NCSE. Benzodiazepines are the mainstay of first-line therapy, with antiepileptic drugs and anesthetics as second- and third-line therapies, respectively. NCSE can be a difficult diagnosis to make in the emergency department setting, but the key to diagnosis is a high index of suspicion coupled with rapid initiation of continuous EEG and early involvement of neurology. Nonconvulsive status epilepticus (NCSE) is characterized by persistent change in mental status from baseline lasting more than 5 minutes, generally with epileptiform activity seen on EEG monitoring and subtle or no motor abnormalities. Indications for Continuous EEG to Diagnose Nonconvulsive Status Epilepticus in the Critically Ill Patient Pharmacotherapy for Nonconvulsive Status Epilepticus Treatment Approach in Nonconvulsive Status Epilepticus, by Subtype Clinical Findings and Risk Factors in Nonconvulsive Status Epilepticus Differential Diagnosis for Nonconvulsive Status Epilepticus Common Etiologies of Nonconvulsive Status Epilepticus Clinical Subtypes and Features of Nonconvulsive Status Epilepticus Clinical Features of Nonconvulsive Status Epilepticus Risk Management Pitfalls for Patients With Nonconvulsive Status Epilepticus in the Emergency DepartmentĬlinical Pathway for Management of Nonconvulsive Status Epilepticus.Abbreviations of Types of Status EpilepticusĬlassification and Taxonomy of Status Epilepticus.