Successful treatment of non-convulsive status epilepticus diagnosed using bedside monitoring by a combination of amplitude-integrated and two-channel simplified electroencephalography.

Autor: Egawa S; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Hifumi T; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Kawakita K; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Manabe A; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Matumura H; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Okazaki T; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Hamaya H; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Shinohara N; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Shishido H; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Takano K; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Abe Y; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Hagiike M; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan., Kuroda Y; Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan.
Jazyk: angličtina
Zdroj: Acute medicine & surgery [Acute Med Surg] 2015 Aug 27; Vol. 3 (2), pp. 167-170. Date of Electronic Publication: 2015 Aug 27 (Print Publication: 2016).
DOI: 10.1002/ams2.156
Abstrakt: Case: A 66-year-old man developed disturbed consciousness and right hemiparesis with transient convulsions in the right arm. Bedside monitoring using a combination of amplitude-integrated electroencephalography and two-channel simplified electroencephalography revealed intermittent episodes of 1-3 Hz δ waves lasting for approximately 5 min, consistent with non-convulsive status epilepticus. Fosphenytoin (22.5 mg/kg/day) and levetiracetam (1,000 mg) prevented right arm convulsions but did not restore consciousness. The two-channel simplified electroencephalography also showed an intermittent periodic δ wave pattern in the Fp1-C3 channel. Conventional electroencephalography revealed a polymorphic δ activity that was abolished by 2.5 mg diazepam, thus confirming the diagnosis of non-convulsive status epilepticus.
Outcome: The patient recovered completely with the antiepileptic drug combination.
Conclusion: Immediate initiation of bedside monitoring using amplitude-integrated electroencephalography and two-channel simplified electroencephalography allows early detection of non-convulsive status epilepticus in patients with disturbed consciousness, which considerably improves the prognosis.
Databáze: MEDLINE
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