Non-Convulsive Status Epilepticus (NCSE)

Etiology

  • Generalized seizure activity that occurs without tonic-clonic movements; Can therefore be hard to detect

Risk Factors

  • Most commonly related to underlying seizure disorder
  • Other contributors include anything that insults the cortex: infection (systemic or CNS), hypoglycemia, hyponatremia, trauma, tumor, stroke, Alzheimers disease, other structural brain disorders, meds, severe illness (in particular, sepsis), substances of above, other toxic/metabolic conditions

Symptoms

  • Waxing and waning level of alertness
  • Confusion that persists
  • New onset inability to follow commands
  • Overall, can be much more subtle than generalized seizure

Physical Exam Findings

  • Eye deviation
  • Blinking
  • Subtle twitching
  • Repeating of words
  • Inability to follow commands