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*Epilepsy - Advances in Diagnosis and Therapy*

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**1. Introduction**

**Chapter 4**

**Abstract**

Nonconvulsive Status Epilepticus

This is a prospective, hospital-based study reporting an update and the prevalence of nonconvulsive status epilepticus (NCSE) in patients with altered mental status (AMS) in Qatar. Patients presenting with NCSE are compared to controls. Two-hundred and fifty patients with AMS are involved. Patients with NCSE are: 65 (12–79 years, m, 37, f, 28); controls: 185 (12–80 years, m, 101, f, 84). Occurrence of NCSE in patients with AMS was 26%. NCSE patients were younger than controls (p < 0.001). Deaths in the NCSE group occurred in 31% and 19% in controls (p < 0.0007). Hospitalization length was longer in NCSE proper and in comatose NCSE compared to controls (p < 0.02, p < 0.03). Recovery occurred in 40% of NCSE patients and 53% of controls (p < 0.08). About 31% of patients (n = 21) had refractory NCSE and 9 died. This is the first study reporting the prevalence of NCSE in Qatar. This prevalence (26%) is in the middle range. NCSE did not do better than the controls, result being disappointing regarding comatose NCSE. NCSE is an emerging condition requiring rapid diagnosis and rapid treatment. Regarding the optimal duration of continuous EGG (cEEG) monitoring to diagnose the major-

ity of NCSE cases, 3 days of cEEG monitoring could accomplish this task.

Nonconvulsive status epilepticus (NCSE) is accompanied with an altered mental status (AMS) without convulsive motor activity [1]. Because of the paucity of clinical symptoms, EEG is mandatory for the diagnosis of NCSE. In the intensive care unit (ICU), where the patient is often obtunded/comatose, cEEG monitoring is required to reveal NCSE. cEEG monitoring is important because of the difficulty distinguishing when AMS and coma are ictal and differentiating them from non-ictal

**Keywords:** nonconvulsive seizures, nonconvulsive status epilepticus,

epidemiology, treatment, antiseizure medications, outcome

in Patients with Altered Mental

General Hospital, Doha, Qatar

*Boulenouar Mesraoua, Dirk Deleu, Hassan Al Hail,* 

*Musab Ali, Naim Haddad, Gayane Melykian,* 

*Yasser Osman M. Ali, Lubna El Sheikh,* 

*Ali A. Asadi-Pooya and Peter Kaplan*

Status Admitted to Hamad
