[S1-1A-2] Nonconvulsive Status Epilepticus in Children
Nonconvulsive Status Epilepticus (NCSE) is traditionally defined as prolonged electrographic seizures resulting in nonconvulsive clinical symptoms, which often manifest as cognitive or behavioral change. In children, this usually presents as a nonspecific encephalopathy and may be a challenge to recognize. The occurrence of NCSE in children as reported in various studies is variable, ranging from 7% to 46%. The etiology of NCSE in children is heterogeneous, and includes hypoxic-ischemic injury, intracranial hemorrhage, acute infections, neurometabolic diseases, and refractory epilepsy. The presence of a convulsive seizure and acute cortical abnormality on neuroimaging has been shown to increase the probability of developing NCSE. The diagnosis of NCSE is difficult to make solely on clinical grounds. Electroencephalography is essential in establishing the diagnosis of NCSE. The prognosis of NCSE is largely dependent on its underlying cause. NCSE in comatose patients has been found to have the worst prognosis. Due to the variability of the outcome of NCSE, treatment is usually dependent on the subtype of NCSE and the circumstances in which it occurs. Benzodiazepines are the first-line agents used. Often, the treatment is less aggressive as compared to convulsive status epilepticus, except in comatose patients who warrant similar treatment. The recognition of NCSE is important because it represents a treatable condition, which may be under diagnosed in pediatric patients presenting with encephalopathy.