Mutis Jorge A, Rodríguez Jesús H, Nava-Mesa Mauricio O
Neurology Department, Fundación CardioInfantil, Hospital Universitario Mayor, University of Rosario, Bogotá, Colombia.
Neuroscience Research Group (NEUROS), University of Rosario, Bogotá, Colombia.
Epilepsy Behav Case Rep. 2016 Nov 9;7:20-23. doi: 10.1016/j.ebcr.2016.11.002. eCollection 2017.
The purpose of this article is to describe the clinical and electroencephalographic features of patients diagnosed with non-convulsive status epilepticus (NCSE) with uncommon cognitive and behavioral involvement. We present two cases with sub-acute cognitive impairment and neuropsychiatric disorders (including anxiety and transient behavioral changes) as their first manifestation of NCSE. A neuropsychological profile demonstrated executive dysfunction. In addition, the neurological examination revealed automatisms and 24-hour video EEG showed epileptiform activity. Although neuroimaging studies showed frontotemporal abnormalities, both neurophysiological and cognitive improvement after specific antiseizure drug treatment confirmed the diagnosis of non-convulsive status. Theoretical considerations between mental status changes and focal epilepsy will be reviewed. Our cases raise awareness of the importance of considering NCSE, a treatable condition, in the differential diagnosis of rapidly-progressive cognitive impairment with neuropsychiatric symptoms.
本文旨在描述诊断为非惊厥性癫痫持续状态（NCSE）且伴有罕见认知和行为受累的患者的临床及脑电图特征。我们报告了两例以亚急性认知障碍和神经精神障碍（包括焦虑和短暂行为改变）为NCSE首发表现的病例。神经心理学评估显示存在执行功能障碍。此外，神经系统检查发现自动症，24小时视频脑电图显示癫痫样活动。尽管神经影像学研究显示额颞叶异常，但特异性抗癫痫药物治疗后神经生理学和认知功能的改善证实了非惊厥性状态的诊断。将对精神状态改变与局灶性癫痫之间的理论关系进行综述。我们的病例提高了人们对于在伴有神经精神症状的快速进展性认知障碍的鉴别诊断中考虑NCSE（一种可治疗的疾病）重要性的认识。
