Article

Nonconvulsive seizures in patients presenting with altered mental status: an evidence-based review.

Department of Emergency Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
Epilepsy & Behavior (impact factor: 2.34). 07/2011; 22(2):139-43. DOI:10.1016/j.yebeh.2011.06.012 pp.139-43
Source: PubMed

ABSTRACT Definitive diagnosis of nonconvulsive seizures (NCS) can be made only by electroencephalography, and delay in diagnosis can increase morbidity, resource utilization, and length of hospitalization. We performed an evidence-based literature review to estimate the prevalence of NCS in patients with altered mental status (AMS) of unknown cause. PUBMED, EMBASE, the Cochrane Library, and other resources were searched for studies that included AMS and seizure as topics. The resulting 276 articles were screened for predetermined inclusion and exclusion criteria, leaving 5 studies enrolling 478 patients for review. The prevalence of NCS in patients with AMS ranged from 8 to 30% (overall prevalence of 21.5%, 95% CI: 18-25%), suggesting that the prevalence of NCS is sufficiently high to consider routine use of urgent electroencephalography in such patients. However, methodological weaknesses limit the generalizability of the results. A large, prospective study enrolling and screening for NCS in all patients who present with acute AMS is needed.

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  • Article: Emergency department management of patients with seizures: a multicenter study.
    J S Huff, D L Morris, R U Kothari, M A Gibbs
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Keywords

5 studies enrolling 478 patients
 
acute AMS
 
AMS
 
Cochrane Library
 
Definitive diagnosis
 
evidence-based literature review
 
exclusion criteria
 
hospitalization
 
included AMS
 
mental status
 
NCS
 
nonconvulsive seizures
 
predetermined inclusion
 
prospective study enrolling
 
resource utilization
 
resources
 
resulting 276 articles
 
routine use
 
seizure
 
urgent electroencephalography