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Aim  The present study aimed to elucidate the clinical characteristics of non‐convulsive status epilepticus ( NCSE ) in patients with altered mental status ( AMS ).    Methods  This single‐center retrospective study comprised 149 patients who were hospitalized between March 1, 2015 and September 30, 2015 at the emergency intensive care unit ( ICU ) of the Kagawa University Hospital (Kagawa, Japan). The primary outcome was  NCSE  incidence. The secondary outcome was the comparison of duration of  ICU  stay, hospital stay, and a favorable neurological outcome, as assessed using the modified Rankin Scale score, at discharge from our hospital between patients with and without  NCSE . Favorable neurological outcome and poor neurological outcome were defined as modified Rankin Scale scores of 0–2 and 3–6, respectively.    Results  Simplified continuous electroencephalogram was used to monitor 36 patients (median age, 68 years; 69.4% males) with acute  AMS ; among them,  NCSE  was observed in 11 (30.1%) patients. Rates of favorable neurological outcome, duration of  ICU  stay, and hospital stay were not significantly different between the  NCSE  and non‐ NCSE  groups ( P  = 0.45,  P  = 0.30, and  P  = 0.26, respectively).    Conclusion  Approximately 30% of the patients with  AMS  admitted to emergency  ICU s developed  NCSE . The outcomes of  AMS  patients with and without  NCSE  did not differ significantly when appropriate medical attention and antiepileptic drugs were initiated. Simplified continuous electroencephalogram monitoring may be recommended in patients with  AMS  in emergency  ICU  to obtain early detection of  NCSE  followed by appropriate intervention.

acute medicine and surgery

Clinical characteristics of non‐convulsive status epilepticus diagnosed by simplified continuous electroencephalogram monitoring at an emergency intensive care unit