Nonconvulsive seizures in patients presenting with altered mental status: An evidence-based review

Epilepsy and Behavior

Volumn 22, Issue 2, 2011, Pages 139-143

  Zehtabchi, Shahriar ^a   Abdel Baki, Samah G ^a,b   Malhotra, Shweta ^a,b   Grant, Arthur C ^a  

^a SUNY DOWNSTATE MEDICAL CENTER   (United States)

^b Bio Signal Group Inc   (United States)

Author keywords

Altered mental status; Electroencephalography; Evidence based medicine; Literature review; Nonconvulsive seizure; Seizure; Status epilepticus

Indexed keywords

BENZODIAZEPINE;

CHILDHOOD DISEASE; DISEASE SEVERITY; ELECTROENCEPHALOGRAM; ELECTROENCEPHALOGRAPHY; EPILEPSY; EVIDENCE BASED MEDICINE; HUMAN; LENGTH OF STAY; MEDICAL HISTORY; MENTAL DISEASE; MORBIDITY; NONCONVULSIVE SEIZURE; PREVALENCE; QUALITY CONTROL; REVIEW; SEIZURE; SYSTEMATIC REVIEW;

DATABASES, FACTUAL; EVIDENCE-BASED MEDICINE; HUMANS; MENTAL DISORDERS; SEIZURES;

EID: 80053384591     PISSN: 15255050     EISSN: 15255069     Source Type: Journal    
DOI: 10.1016/j.yebeh.2011.06.012     Document Type: Review

References (30)

1. Bastani A., Kayyali H., Schmidt R., Qadir R., Manthena P. Wireless brain monitoring in the emergency department. Conf Proc IEEE Eng Med Biol Soc 2005, 3:2502-2505.
2. Young G.B., Jordan K.G., Doig G.S. An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring: an investigation of variables associated with mortality. Neurology 1996, 47:83-89.
3. Krumholz A. Epidemiology and evidence for morbidity of nonconvulsive status epilepticus. J Clin Neurophysiol 1999, 16:314-322. discussion 353.
4. Kaplan P.W. The clinical features, diagnosis, and prognosis of nonconvulsive status epilepticus. Neurologist 2005, 11:348-361.
5. Young G.B., Claassen J. Nonconvulsive status epilepticus and brain damage: further evidence, more questions. Neurology 2010, 75:760-761.
6. Varelas P.N., Mirski M.A. Management of seizures in critically ill patients. Curr Neurol Neurosci Rep 2004, 4:489-496.
7. Kaplan P.W. Assessing the outcomes in patients with nonconvulsive status epilepticus: nonconvulsive status epilepticus is underdiagnosed, potentially overtreated, and confounded by comorbidity. J Clin Neurophysiol 1999, 16:341-352.
8. Drislane F.W. Presentation, evaluation, and treatment of nonconvulsive status epilepticus. Epilepsy Behav 2000, 1:301-314.
9. Huff J.S., Morris D.L., Kothari R.U., Gibbs M.A. Emergency department management of patients with seizures: a multicenter study. Acad Emerg Med 2001, 8:622-628.
10. Lowenstein D.H., Bleck T., Macdonald R.L. It's time to revise the definition of status epilepticus. Epilepsia 1999, 40:120-122.
11. Bautista R.E., Godwin S., Caro D. Incorporating abbreviated EEGs in the initial workup of patients who present to the emergency room with mental status changes of unknown etiology. J Clin Neurophysiol 2007, 24:16-21.
12. Wiley InterScience The Cochrane Library Available at:, Accessed: April 8, 2011. http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/home.
13. The Center for Medical Education Emergency Medical Abstracts Available at:, Accessed: April 8, 2011. http://ccme.org.
14. Best Evidence Topics: BestBETS Available at:, Accessed: April 8, 2011. http://bestbets.org.
15. Saengpattrachai M., Sharma R., Hunjan A., et al. Nonconvulsive seizures in the pediatric intensive care unit: etiology, EEG, and brain imaging findings. Epilepsia 2006, 47:1510-1518.
16. Praline J., Grujic J., Corcia P., et al. Emergent EEG in clinical practice. Clin Neurophysiol 2007, 118:2149-2155.
17. Kapadia F.N., Vadi S., Shukla U., Gursahani R. Utility of electroencephalogram in altered states of consciousness in intensive care unit patients. Indian J Crit Care Med 2005, 9:19-21.
18. Privitera M., Hoffman M., Moore J.L., Jester D. EEG detection of nontonic-clonic status epilepticus in patients with altered consciousness. Epilepsy Res 1994, 18:155-166.
19. Juni P., Witschi A., Bloch R., Egger M. The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 1999, 282:1054-1060.
20. Available at:, Accessed: April 8, 2011. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
21. Agency for Healthcare Research and Quality Systems to rate the strength of scientific evidence Available at:, Accessed: April 8, 2011. http://www.ahrq.gov/clinic/tp/strengthtp.htm.
22. Guyatt G., Rennie D., Meade M.O., Cook D. Users' guide to the medical literature: a manual for evidence-based clinical practice 2002, McGraw-Hill, Columbus, OH. 2nd ed.
23. Claassen J., Mayer S.A., Kowalski R.G., Emerson R.G., Hirsch L.J. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology 2004, 62:1743-1748.
24. Young G.B., Doig G.S. Continuous EEG monitoring in comatose intensive care patients: epileptiform activity in etiologically distinct groups. Neurocrit Care 2005, 2:5-10.
25. Towne A.R., Waterhouse E.J., Boggs J.G., et al. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology 2000, 54:340-345.
26. Alehan F.K., Morton L.D., Pellock J.M. Utility of electroencephalography in the pediatric emergency department. J Child Neurol 2001, 16:484-487.
27. Tay S.K., Hirsch L.J., Leary L., Jette N., Wittman J., Akman C.I. Nonconvulsive status epilepticus in children: clinical and EEG characteristics. Epilepsia 2006, 47:1504-1509.
28. Kaplan P.W. Nonconvulsive status epilepticus in the emergency room. Epilepsia 1996, 37:643-650.
29. Cocito L., Primavera A. Diagnostic delay of nonconvulsive status epilepticus in adults. Electroencephalogr Clin Neurophysiol 1997, 103:173.
30. Firosh Khan S., Ashalatha R., Thomas S.V., Sarma P.S. Emergent EEG is helpful in neurology critical care practice. Clin Neurophysiol 2005, 116:2454-2459.