Department of Pediatrics, Division of Pediatric Neurology, Columbia University School of Physicians & Surgeons, Morgan Children's Hospital at New York Presbyterian, New York, NY, USA.
Semin Pediatr Neurol. 2010 Sep;17(3):155-62. doi: 10.1016/j.spen.2010.06.009.
Nonconvulsive status epilepticus (NCSE) is a special epileptic state that can be more common than previously thought in children and adult patients. Currently, there is no universally accepted definition for NCSE. Early and accurate diagnosis depends on a high index of suspicion and rapid availability of electroencephalographic recording. The clinical presentation of NCSE can vary from a mild confusional state to a coma. The underlying etiology is also quite diverse. In critically ill patients, NCSE has been reported with convulsive status epilepticus (CSE), hypoxemia, acute ischemic or hemorrhagic stroke, encephalitis, or trauma. The estimated incidence of NCSE is 15% to 40% in post-CSE, 8% in subarachnoid hemorrhage, and 8% to 10% in coma. As seen in CSE, there is a bimodal distribution with NCSE in critically ill patients; children (age <1 year) and elderly appear to be at great risk. NCSE has also been reported in a number of epilepsy syndromes, such as childhood absence epilepsy, Panayiotopoulos syndrome, Lennox-Gastaut syndrome, and Dravet syndrome. However, it is difficult to determine the incidence of NCSE in an ambulatory setting because of the great variation in clinical presentation and underlying etiology. This review examines the clinical features, outcome, and treatment approach for NCSE in 2 different clinical settings, in ambulatory and critically ill patients. NCSE is reviewed in children and adults to distinguish similarities and differences in their clinical presentation.
非惊厥性癫痫持续状态（NCSE）是一种特殊的癫痫状态，在儿童和成年患者中可能比以前认为的更为常见。目前，NCSE 尚无普遍接受的定义。早期和准确的诊断取决于高度怀疑和快速获得脑电图记录。NCSE 的临床表现从轻度意识障碍到昏迷不等。其潜在病因也相当多样化。在危重病患者中，已报道 NCSE 与癫痫持续状态（CSE）、低氧血症、急性缺血性或出血性中风、脑炎或创伤有关。CSE 后 NCSE 的估计发生率为 15%至 40%，蛛网膜下腔出血为 8%，昏迷为 8%至 10%。与 CSE 一样，危重病患者的 NCSE 呈双峰分布；儿童（<1 岁）和老年人似乎风险很大。NCSE 也在一些癫痫综合征中报道，如儿童失神癫痫、Panayiotopoulos 综合征、Lennox-Gastaut 综合征和 Dravet 综合征。然而，由于临床表现和潜在病因的巨大差异，很难确定在门诊环境中 NCSE 的发生率。这篇综述检查了 NCSE 在门诊和危重病患者两种不同临床环境中的临床特征、结果和治疗方法。NCSE 在儿童和成人中进行了综述，以区分其临床表现的相似和不同之处。
