Octaviana Fitri, Bestari Andriani P, Loho Anastasia M, Indrawati Luh A, Wiratman Winnugroho, Kurniawan Mohammad, Sugiarto Adhrie, Budikayanti Astri
Department of Neurology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Neurol India. 2021 Mar-Apr;69(2):354-359. doi: 10.4103/0028-3886.314533.
Nonconvulsive status epilepticus (NCSE) is often underdiagnosed in patients with metabolic encephalopathy (ME). The diagnosis of ME should be made specifically to recognize the underlying etiology. Delay in seizure identification and making a diagnosis of NCSE contributed to the poor outcome.
This study aimed to find the incidence and outcome of NCSE in patients with ME.
This was an observational prospective cross-sectional study in patients with ME in emergency and critical care units in Cipto Mangunkusumo General Hospital. The diagnosis of NCSE was based on EEG using Salzburg Criteria for Nonconvulsive Status Epilepticus (SCNC). The outcome was assessed within 30 days after the NCSE diagnosis has been made.
A total of 50 patients with ME were involved in this study. NCSE was confirmed in 32 subjects (64%). The most common etiology of ME was sepsis (58%). The mortality rate in the NCSE and non-NCSE group was 40.6% vs 44.4%. Multiple aetiologies were risk factors to poor outcome in the NCSE group.
The incidence of NCSE among patients with ME at our hospital was high. Despite the anti-epileptic treatment of the NCSE group, the underlying cause of ME is still the main factor that affected the outcome. Therefore, aggressive treatment of anti-epileptic drug (AED) should be very carefully considered knowing the possible side-effect that might worsen the outcome of patients with ME.
非惊厥性癫痫持续状态（NCSE）在代谢性脑病（ME）患者中常被漏诊。应明确做出ME的诊断以识别潜在病因。癫痫发作识别及NCSE诊断的延迟导致了不良预后。
本研究旨在探寻ME患者中NCSE的发生率及预后情况。
这是一项在西爪哇省芝柏图·曼古库苏莫综合医院急诊及重症监护病房对ME患者进行的前瞻性观察性横断面研究。NCSE的诊断基于使用萨尔茨堡非惊厥性癫痫持续状态标准（SCNC）的脑电图检查。在做出NCSE诊断后30天内评估预后情况。
本研究共纳入50例ME患者。32例受试者（64%）确诊为NCSE。ME最常见的病因是脓毒症（58%）。NCSE组和非NCSE组的死亡率分别为40.6%和44.4%。多种病因是NCSE组预后不良的危险因素。
我院ME患者中NCSE的发生率较高。尽管对NCSE组进行了抗癫痫治疗，但ME的潜在病因仍是影响预后的主要因素。因此，鉴于抗癫痫药物（AED）可能产生的副作用会使ME患者的预后恶化，应非常谨慎地考虑积极使用AED进行治疗。
