Prolonged postictal stupor: nonconvulsive status epilepticus, medication effect, or postictal state?
We describe a patient who entered a stuporous state after receiving benzodiazepine treatment for generalized tonic-clonic status epilepticus. A diagnosis of generalized NCSE with tonic seizures was made on the basis of the clinical picture and response to barbiturate anaesthetic, although the EEG pattern was not typical of the changes previously described in tonic seizures-tonic status epilepticus. This report discusses the differential diagnosis of postictal stupor, nonconvulsive status epilepticus with tonic seizures and sedation caused by the emergency treatment of status epilepticus, and summarizes the literature on tonic seizures and tonic status epilepticus.
Langheinrich
Tobias Christoph
TC
Neurology, Sheffield Teaching Hospital NHS Trust, Glossop Road, Sheffield, South Yorkshire S10 2JF, UK. tobias.langheinrich@sth.nhs.uk
Chattopadhyay
Arup
A
Kuc
Sue
S
Reuber
Markus
M
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D003128:Coma / Q000209:etiology* / Q000523:psychology*; D003937:Diagnosis, Differential; D004569:Electroencephalography; D017029:Epilepsy, Complex Partial / Q000150:complications / Q000188:drug therapy; D004829:Epilepsy, Generalized / Q000150:complications / Q000188:drug therapy; D004830:Epilepsy, Tonic-Clonic / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000150:complications; D010634:Phenobarbital / Q000627:therapeutic use; D012640:Seizures / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D013226:Status Epilepticus / Q000523:psychology*; D013874:Thiopental / Q000009:adverse effects / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D001569:Benzodiazepines; D014635:Valproic Acid; D013874:Thiopental; D010634:Phenobarbital