Open AccessSuccessful treatment of non‐convulsive status epilepticus diagnosed using bedside monitoring by a combination of amplitude‐integrated and two‐channel simplified electroencephalography
Author(s) -
Egawa Satoshi,
Hifumi Toru,
Kawakita Kenya,
Manabe Arisa,
Matumura Hikari,
Okazaki Tomoya,
Hamaya Hideyuki,
Shinohara Natuyo,
Shishido Hajime,
Takano Koshiro,
Abe Yuko,
Hagiike Masanobu,
Kuroda Yasuhiro
Publication year - 2016
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.156
Subject(s) - electroencephalography , status epilepticus , anesthesia , levetiracetam , medicine , epilepsy , delta wave , psychiatry , slow wave sleep
Case A 66‐year‐old man developed disturbed consciousness and right hemiparesis with transient convulsions in the right arm. Bedside monitoring using a combination of amplitude‐integrated electroencephalography and two‐channel simplified electroencephalography revealed intermittent episodes of 1–3 Hz δ waves lasting for approximately 5 min, consistent with non‐convulsive status epilepticus. Fosphenytoin (22.5 mg/kg/day) and levetiracetam (1,000 mg) prevented right arm convulsions but did not restore consciousness. The two‐channel simplified electroencephalography also showed an intermittent periodic δ wave pattern in the Fp1‐C3 channel. Conventional electroencephalography revealed a polymorphic δ activity that was abolished by 2.5 mg diazepam, thus confirming the diagnosis of non‐convulsive status epilepticus. Outcome The patient recovered completely with the antiepileptic drug combination. Conclusion Immediate initiation of bedside monitoring using amplitude‐integrated electroencephalography and two‐channel simplified electroencephalography allows early detection of non‐convulsive status epilepticus in patients with disturbed consciousness, which considerably improves the prognosis.