Modern concepts of status epilepticus
G. G. Celesia
Among 60 cases of status epilepticus, there were 45 cases of convulsive
status and 15 cases of nonconvulsive or confusional status. In 37 cases,
status was due to an identifiable cause. The most frequent etiologic
factors were vascular (nine cases), traumatic (seven cases), and metabolic
(five cases). Four patients with metabolic encephalopathy had focal status.
While the possibility of expanding lesions should be investigated in every
case of convulsive status, a complete metabolic screening is also
necessary. Non-convulsive status was represented by two cases of
psychomotor status and 13 cases of absence status. Clinically, these cases
were characterized by various impairments of intellectual functioning and
confusion. Diagnosis was determined by characteristic changes in the
electroencephalogram. Aggressive treatment is indicated by one or more of
the major anticonvulsants, supplemented by adequate oxygenation and
maintenance of biochemical homeostasis.
