Nonconvulsive status epilepticus and the postictal state

Postictal symptoms, because of activation of inhibitory systems, have to be distinguished from ongoing ictal activity. The categorical concept of pure ictal and pure postictal symptoms cannot be supported by clinical observation alone. Differentiation between postictal and ictal behavioral phenomena can be difficult even with the use of electroencephalography, as clear-cut definitions of ictal and postictal changes are not available. Five different aspects can be considered: (1) hallucinatory symptoms recorded during and after a seizure, (2) prolonged postictal confusional states, (3) prolonged postictal psychotic states, (4) epileptic and other encephalopathies, and (5) coma with or without clinical signs of nonconvulsive status epilepticus. Presenting symptoms and conceptual considerations are presented in this review.

[1]  M. Baulac,et al.  The drug treatment of status epilepticus in Europe: Consensus document from a workshop at the first London Colloquium on Status Epilepticus , 2008, Epilepsia.

[2]  O. Devinsky,et al.  Two Cases of Nonconvulsive Status Epilepticus in Association with Tiagabine Therapy , 1999, Epilepsia.

[3]  S. Shorvon,et al.  Delusions, illusions and hallucinations in epilepsy: 1. Elementary phenomena , 2009, Epilepsy Research.

[4]  S. Shorvon.  Status Epilepticus: Its Clinical Features and Treatment in Children and Adults , 1994 .

[5]  Simon Shorvon,et al.  What is nonconvulsive status epilepticus, and what are its subtypes? , 2007, Epilepsia.

[6]  P Gloor,et al.  Experiential phenomena of temporal lobe epilepsy. Facts and hypotheses. , 1990, Brain : a journal of neurology.

[7]  R. Brenner.  How useful is EEG and EEG monitoring in the acutely ill and how to interpret it? , 2009, Epilepsia.

[8]  M. Krom,et al.  Status epilepticus during vigabatrin treatment: A report of three cases , 1995, Seizure.

[9]  A. Cross,et al.  Acute aphasia in multiple sclerosis. , 2000, Archives of neurology.

[10]  K. Kanemoto,et al.  A Prospective Study of Postictal Psychoses with Emphasis on the Periictal Type , 2006, Epilepsia.

[11]  A. Husain,et al.  Non-convulsive status epilepticus: usefulness of clinical features in selecting patients for urgent EEG , 2003, Journal of neurology, neurosurgery, and psychiatry.

[12]  Peter W Kaplan,et al.  Nonconvulsive status epilepticus. , 1996, Neurology.

[13]  Prefrontal disturbances as the sole manifestation of simple partial nonconvulsive status epilepticus , 2006, Epilepsy & Behavior.

[14]  P. Gloor,et al.  The role of the limbic system in experiential phenomena of temporal lobe epilepsy , 1982, Annals of neurology.

[15]  F Aichner,et al.  Nonconvulsive status epilepticus following generalized tonic-clonic seizures. , 1982, European neurology.

[16]  L. P. Clark,et al.  STATUS EPILEPTICUS: A CLINICAL AND PATHOLOGICAL STUDY IN EPILEPSY , 1904 .

[17]  P. Eames,et al.  Complex partial status after starting vigabatrin , 1993, Seizure.

[18]  H. Alpay,et al.  Cefepime-induced non-convulsive status epilepticus in a peritoneal dialysis patient , 2004, Pediatric Nephrology.

[19]  A. Arzimanoglou.  Vigabatrin and complex partial status. , 1994, Seizure.

[20]  R. Sawyer,et al.  Cefepime-Associated Status Epilepticus in an ICU Patient with Renal Failure , 2009, Journal of chemotherapy.

[21]  E. Waterhouse,et al.  Persistent Nonconvulsive Status Epilepticus After the Control of Convulsive Status Epilepticus , 1998, Epilepsia.

[22]  T. Landis,et al.  Unilateral Limbic Epileptic Status Activity: Stereo EEG, Behavioral, and Cognitive Data , 1985, Epilepsia.

[23]  H. Wieser.  Temporal lobe or psychomotor status epilepticus. A case report. , 1980, Electroencephalography and clinical neurophysiology.

[24]  R. Maganti,et al.  Nonconvulsive status epilepticus due to cefepime in a patient with normal renal function , 2006, Epilepsy & Behavior.

[25]  B. Tabarki,et al.  Cefepime-Induced Nonconvulsive Status Epilepticus: Case Report and Review , 2009, Neurocritical care.

[26]  E. Trinka,et al.  Nonconvulsive status epilepticus and coma , 2010, Epilepsia.

[27]  K. Fagan,et al.  Prolonged confusion following convulsions due to generalized nonconvulsive status epilepticus , 1990, Neurology.

[28]  W. Hauser,et al.  Status Epilepticus and Tiagabine Therapy: Review of Safety Data and Epidemiologic Comparisons , 2001, Epilepsia.

[29]  F. Drislane.  Presentation, Evaluation, and Treatment of Nonconvulsive Status Epilepticus , 2000, Epilepsy & Behavior.

[30]  D. Treiman,et al.  Subtle generalized convulsive status epilepticus , 1984 .

[31]  Peter W Kaplan,et al.  EEG criteria for nonconvulsive status epilepticus , 2007, Epilepsia.

[32]  Richard P Brenner,et al.  The Interpretation of the EEG in Stupor and Coma , 2005, The neurologist.

[33]  S. Shorvon,et al.  Delusions, illusions and hallucinations in epilepsy: 2. Complex phenomena and psychosis , 2009, Epilepsy Research.

[34]  H. G. Wieser,et al.  Depth recorded limbic seizures and psychopathology , 1983, Neuroscience & Biobehavioral Reviews.

[35]  B. Steinhoff,et al.  Clinical and EEG findings in complex partial status epilepticus with tiagabine , 1999, Seizure.

[36]  R. Sheth,et al.  Status epilepticus associated with cefepime , 2000, Neurology.

[37]  E. Trinka,et al.  De novo aphasic status epilepticus as presenting symptom of multiple sclerosis , 2002, Journal of Neurology.