No, some types of nonconvulsive status epilepticus cause little permanent neurologic sequelae (or: "The cure may be worse than the disease")

Nonconvulsive status epilepticus (NCSE) is characterized by a cognitive or behavioral change which lasts for at least 30 minutes, with EEG evidence of seizures. Although there is little argument that generalized nonconvulsive status epilepticus (GNSE) does not cause lasting deficits, there is still debate regarding the morbidity of complex partial status epilepticus (GPSE) . Because the EEG is used for diagnosis, a strong argument can be made that NCSE is significantly under-recognized and diagnosed. Furthermore, since t he documented cases of permanent neurologic sequelae are few, the potential permanent morbidity from CPSE may be significantly exaggerated. The litera ture indicates that comatose patients have a poor prognosis largely as a re sult of comorbid conditions and coma, whereas lightly obtunded or slightly confused patients with NCSE have little or no sequelae. Patients with NCSE may suffer (hypotension and respiratory suppression) from iatrogenic 'aggre ssive' treatment with intravenous anti-epileptic drugs (IV-AEDs), and the f indings in the literature indicate that subjects treated with benzodiazepin es may have a worse prognosis. The clinician must balance the potential but rare neurologic morbidity associated with NCSE against the not infrequent morbidity caused by IV-AEDs. Better stratification of the level of consciou sness and comorbid conditions is needed when evaluating outcomes so as to c learly distinguish among the deficits due to: comorbid conditions; the effe cts of treatment and the effects of status epilepticus (SE) proper. (C) 200 0 Editions scientifiques et medicales Elsevier SAS.