Hospital da Luz, Neurology Department, Member of the ERN EpiCARE, Lisbon, Portugal.
Epileptic Disord. 2020 Apr 1;22(2):229-232. doi: 10.1684/epd.2020.1149.
De novo absence status is clinically characterized by a confusional syndrome and neurophysiologically by the presence of periodic spike/polyspike-and-wave discharges on EEG. The treatment should be started promptly, and fast recovery is usually seen. However, cognitive symptoms can be very difficult to detect, and no consensus exists on how cognitive improvement can be clinically monitored. We report a patient with absence status epilepticus, whose therapeutic response was monitored neurophysiologically with EEG and clinically with a cognitive test; the Montreal Cognitive Assessment (MoCA). Based on this case report, we describe the use of the MoCA for monitoring cognitive function in a patient with absence status epilepticus. MoCA was evaluated on three occasions, with a total score ranging from 9, before treatment, to 23, when an EEG with no epileptiform discharges was obtained. We suggest that MoCA may be a useful tool to monitor cognitive improvement in absence status epilepticus.
新发生的失神发作在临床上以意识混乱为特征，神经生理学上以脑电图出现周期性棘慢波或多棘慢波放电为特征。应立即开始治疗，通常可迅速恢复。然而，认知症状可能很难被发现，而且对于如何通过临床监测来评估认知改善，目前尚未达成共识。我们报告了一例失神状态发作的患者，其治疗反应通过脑电图进行神经生理学监测，通过认知测试（蒙特利尔认知评估量表，MoCA）进行临床监测。基于此病例报告，我们描述了在失神状态发作的患者中使用 MoCA 来监测认知功能。MoCA 在三个时间点进行了评估，治疗前总分为 9 分，当获得无癫痫样放电的脑电图时，总分为 23 分。我们建议 MoCA 可能是监测失神状态发作患者认知改善的有用工具。
