COMPLEX PARTIAL STATUS EPILEPTICUS ACCOMPANIED BY SERIOUS MORBIDITY AND MORTALITY

Nonconvulsive status epilepticus (NCSE) accounts for approximately 20% of all status epilepticus (SE). Although convulsive SE is recognized as a medical emergency, prompt diagnosis and treatment of patients wit h NCSE is often not emphasized because its consequences are thought to be benign. We report 10 patients with persistent neurologic deficits or death after well-documented NCSE in the form of complex partial sta tus epilepticus (CPSE). All patients had prolonged CPSE lasting 36 hou rs or longer, as documented by clinical and EEG findings. Causes for C PSE were preexisting epilepsy with partial and secondarily generalized seizures (3 patients), vascular disease (2 patients), encephalitis (2 patients), and metabolic disease (1 patient); causes were unknown for two patients. Poor outcomes identified included persistent (lasting a t least 3 months) or permanent cognitive or memory loss (5 patients), cognitive or memory loss plus motor and sensory dysfunction (3 patient s), and death (3 patients). NCSE in the form of CPSE is not a benign e ntity. Serious morbidity and mortality may occur due to the adverse ef fects of prolonged seizures and as a result of acute brain disorders t hat precipitate the seizures.