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Convulsive and non-convulsive status epilepticus 

Convulsive and non-convulsive status epilepticus
Chapter:
Convulsive and non-convulsive status epilepticus
Author(s):

Matthew C. Walker

DOI:
10.1093/med/9780199688395.003.0030
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date: 07 April 2020

This chapter describes the definition, epidemiology, classification, diagnosis, and treatment of status epilepticus, concentrating on the roles that electroencephalography (EEG) plays. The term status epilepticus now encompasses a range of conditions from continuous convulsive seizures to clinically subtle non-convulsive seizures, which may manifest as changes in behaviour or personality. EEG is critical for the diagnosis of non-convulsive status epilepticus. Furthermore, the progression of convulsive status epilepticus is to an electromechanical dissociation in which continuous electrical seizure activity may have no or minimal clinical manifestations. In the later stages of status epilepticus, EEG is necessary to monitor treatment, but is confounded by the interpretation of periodic EEG patterns, which represent a continuum from interictal through to ictal activity. Post-status epilepticus EEG patterns have prognostic value: periodic epileptiform discharges, burst suppression patterns (off anaesthesia) and repetitive seizure activity are indicative of a poor long-term prognosis.

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