An update on the recognition and treatment of non-convulsive status epilepticus in the intensive care unit

ABSTRACT

Introduction: Non-convulsive status epilepticus (NCSE) is a complex and diverse condition which is often an under-recognised entity in the intensive care unit. When NCSE is identified the optimal treatment strategy is not always clear.

Areas covered: This review is based on a literature review of the key literature in the field over the last 5–10 years. The articles were selected based on their importance to the field by the authors.

Expert commentary: This review discusses the complex situations when a neurological consultation may occur in a critical care setting and provides an update on the latest evidence regarding the recognition of NCSE and the decision making around determining the aggressiveness of treatment. It also considers the ictal-interictal continuum of conditions which may be met with, particularly in the era of continuous EEG, and provides an approach for dealing with these. Suggestions for how the field will develop are discussed.

KEYWORDS:

• Seizure
• non-convulsive status epilepticus
• convulsive status epilepticus
• neurocritical care
• intensive care

Acknowledgement

Many thanks to Mrs Carol Montgomery and the consultant staff in the Department of Neurophysiology for providing the EEG examples provided.

Declaration of interest

P Kaplan has provided unsponsored grand rounds and published books on EEG, status epilepticus, and epilepsy for which he has received honoraria, and receives the Qatar Research Foundation Grant. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.