• Saad Warraich, Abbas Ali, Atif Nizami, and Moiz Bakhiet.
• King Hamad University Hospital, Al Sayh Department of Molecular Medicine, College of Medicine and Medical Science, Arabian Gulf University, Manama Princess Al-Jawhara Center for Molecular Medicine, Genetics and Inherited Disorders, Manama, Kingdom of Bahrain.
• Medicine (Baltimore). 2018 Feb 1; 97 (7): e9950.

RationaleNonconvulsive status epilepticus (NCSE) is prolonged seizure activity without motor manifestations. Clinically, there are certain examination findings, in addition to elements of history, that help differentiate it from other encephalopathies. When diagnosing NCSE, the physician faces significant difficulties due to inconsistent clinical presentation and somewhat nonspecific electroencephalogram (EEG) criteria.Patient ConcernsTo highlight the problems faced when dealing with such a patient, a case of a 29-year-old male who presented with an altered state of consciousness is put forth for the reader. Only after an extensive laboratory and radiological workup had ruled out other causes, an eventual diagnosis was established when clinical features were correlated with suggestive EEG results.DiagnosesThe diagnosis that was reached was NCSE.InterventionsThe initial therapeutic interventions generally deployed in such a scenario ultimately failed and consequently the patient had to be sedated and intubated, while being kept on antiepileptic medication.OutcomesThis measure resulted in satisfactory recovery.LessonsAccordingly, we recommend consideration of NCSE in any unconscious patient whose presentation cannot be explained by other disorders. Furthermore, we suggest moving directly to utilizing anesthetic agents and endotracheal intubation, together with anti-epileptic drugs, in the treatment regimen in order to optimize patient outcomes.

15 keywords...

hide…