Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia.
F1000Res. 2024 Jan 24;12:1155. doi: 10.12688/f1000research.135482.2. eCollection 2023.
INTRODUCTION/BACKGROUND: Non convulsive seizures (NCS) following traumatic brain injury (TBI) may remain undiagnosed due to lack of overt clinical manifestation and can have long-term sequelae due to delay in timely treatment. Occurrence of early NCS is known to have subsequent neurologic sequelae due to excitotoxic neuronal injury.
This is a case report of a young girl who sustained a TBI due to a motor vehicle accident (MVA) and was admitted with a fluctuating level of consciousness. Her clinical presentation was attributed to TBI; however as her conscious level did not recover, an electroencephalogram (EEG) was requested, which detected non convulsive status epilepticus (NCSE). Anti-seizure medication (ASM) was started. Her follow-up EEG and magnetic resonance imaging (MRI) were suggestive of the potential adverse effects of prolonged NCSE.
NCS may remain undiagnosed in TBI due to a paucity of overt clinical manifestations. Every patient with TBI and altered consciousness at presentation should be evaluated by continuous EEG monitoring immediately, if possible, in the emergency department to avoid long-term sequelae of NCS in such cases.
简介/背景：颅脑损伤（TBI）后可能会出现无惊厥性发作（NCS），由于缺乏明显的临床表现，可能会漏诊，并且由于未能及时治疗，可能会产生长期的后遗症。已知早期 NCS 的发生会由于兴奋毒性神经元损伤而导致随后出现神经后遗症。
这是一例因机动车事故（MVA）导致颅脑损伤的年轻女孩，她因意识水平波动而入院。她的临床表现归因于 TBI；然而，由于她的意识水平没有恢复，因此要求进行脑电图（EEG）检查，该检查检测到非惊厥性癫痫持续状态（NCSE）。开始使用抗癫痫药物（ASM）。她的后续脑电图和磁共振成像（MRI）显示出潜在的不良反应。
由于临床表现不明显，TBI 中可能会漏诊 NCS。对于每个 TBI 患者，无论意识状态如何，在出现改变时都应立即通过连续 EEG 监测进行评估，如果可能的话，应在急诊室进行评估，以避免此类情况下 NCS 的长期后遗症。
