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

摘要

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.