Non-convulsive status epilepticus: usefulness of clinical features in selecting patients for urgent EEG.
J Neurol Neurosurg Psychiatry
; 74(2): 189-91, 2003 Feb.
Article
em En
| MEDLINE
| ID: mdl-12531946
ABSTRACT
BACKGROUND:
Non-convulsive status epilepticus (NCSE) is status epilepticus without obvious tonic-clonic activity. Patients with NCSE have altered mental state. An EEG is needed to confirm the diagnosis, but obtaining an EEG on every patient with altered mental state is not practical.OBJECTIVE:
To determine whether clinical features could be used to predict which patients were more likely to be in NCSE and thus in need of an urgent EEG.METHODS:
Over a six month period, all patients for whom an urgent EEG was ordered to identify NCSE were enrolled. Neurology residents examined the patients and filled out a questionnaire without knowledge of the EEG results. The patients were divided into two groups, NCSE and non-NCSE, depending on the EEG result. The clinical features were compared between the two groups. The sensitivity and specificity of the features were calculated.RESULTS:
48 patients were enrolled, 12 in NCSE and 36 not in NCSE. Remote risk factors for seizures, severely impaired mental state, and ocular movement abnormalities were seen significantly more often in the NCSE group. The combined sensitivity of remote risk factors for seizures and ocular movement abnormalities was 100%.CONCLUSIONS:
There are certain clinical features that are more likely to be present in patients in NCSE compared with other types of encephalopathy. Either remote risk factors for seizures or ocular movement abnormalities were seen in all patients in NCSE. These features may be used to select which patients should have an urgent EEG.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estado Epiléptico
/
Escala de Coma de Glasgow
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Seleção de Pacientes
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Eletroencefalografia
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Exame Neurológico
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Neurol Neurosurg Psychiatry
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Estados Unidos