Faculdade de Medicina, Pós-graduação em Ciências da Saúde, Brazil; Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.
Epilepsy Behav. 2024 Sep;158:109929. doi: 10.1016/j.yebeh.2024.109929. Epub 2024 Jul 12.
The clinical-EEG profile and prognosis in nonconvulsive status epilepticus (NCSE-coma) - with preceding SE and without preceding SE - have not been fully established yet.
To evaluate the initial EEG, clinical characteristics, and hospital outcome of older adults with NCSE-coma.
Clinical variables, immediate prognosis, initial EEG data, and scores on the Status Epilepticus Severity Score (STESS) and the SACE score were evaluated according to the type of NCSE-coma (with and without preceding seizure/SE) in 51 older adult patients treated in the emergency department.
The mean age of the participants was 72.2 years. In 23 cases, the diagnosis was NCSE-coma with preceding seizure/SE, and in 28 cases the diagnosis was NCSE-coma without preceding seizure/SE. Previous history of seizures/epilepsy occurred in 11 cases (21.5 %), and was more frequent in NCSE-coma with preceding seizure/SE. The most common etiology was acute. Death within 30 days occurred in 21 cases (41.1 %), but there was no difference between types of NCSE-coma. The predominant EEG finding was the presence of epileptiform discharges/rhythmic delta activity showing morphological/spatial/temporal evolution (classified as A2 in the Salzburg Consensus Criteria [SCC]). There was a significant difference in EEG findings according to the type of NCSE-coma. Total SACE scores averaged 0.9 ± 0.8; on the STESS, it was 4.7 ± 0.4. In the SACE score, the highest total score and a more significant occurrence of scores ≥ 3 (indicating a better prognosis) were observed in NCSE-coma with preceding seizure/SE.
In older adults, the types of NCSE-coma presented different clinical aspects and patterns on initial EEG. The mortality rates were elevated. The most prevalent EEG findings encompass criteria A2 of the SCC. A history of previous seizures/epilepsy and a more favorable prognosis in the SACE score occurred in NCSE-coma with preceding seizure/SE.
非惊厥性癫痫持续状态（NCSE-昏迷）-有或无前癫痫持续状态（SE）的临床-脑电图特征和预后尚未完全确定。
评估老年非惊厥性癫痫持续状态昏迷患者的初始脑电图、临床特征和住院结局。
根据 51 例在急诊科治疗的老年患者的 NCSE-昏迷类型（有或无前癫痫发作/SE），评估临床变量、即刻预后、初始脑电图数据以及癫痫持续状态严重程度评分（STESS）和 SACE 评分。
参与者的平均年龄为 72.2 岁。23 例诊断为有癫痫发作/SE 的 NCSE-昏迷，28 例诊断为无癫痫发作/SE 的 NCSE-昏迷。有癫痫/癫痫发作史的 11 例（21.5%），且在有癫痫发作/SE 的 NCSE-昏迷中更为常见。最常见的病因是急性的。30 天内死亡 21 例（41.1%），但两种 NCSE-昏迷类型之间无差异。最常见的脑电图发现是存在癫痫样放电/节律性德尔塔活动，表现出形态学/空间/时间演变（根据萨尔茨堡共识标准[SCC]分类为 A2）。根据 NCSE-昏迷类型，脑电图发现存在显著差异。总 SACE 评分为 0.9±0.8；STESS 评分为 4.7±0.4。在 SACE 评分中，有癫痫发作/SE 的 NCSE-昏迷的总评分最高，且≥3 分的评分更常见（表明预后更好）。
在老年人中，NCSE-昏迷的类型表现出不同的临床特征和初始脑电图模式。死亡率较高。最常见的脑电图发现包括 SCC 的 A2 标准。有癫痫/癫痫发作史和 SACE 评分中更有利的预后见于有癫痫发作/SE 的 NCSE-昏迷。
