title: [Delirium caused by nonconvulsive status epilepticus].
abstract: We report about a patient (66 years) who was referred to our psychiatric hospital because of a progressive confusional state with acute onset. The colleagues of the referring psychiatric hospital considered a first manic episode as the cause of the symptoms and under therapy with haloperidol the confusional state had shown a progression.The clinical examination's findings were a mild central facial paresis on the right side and a mild hemiparesis on the right side with elevated reflex levels.The patient was disoriented, he had cognitive and mnestic deficits. His reasoning was slowed, incoherent and perseverating. The patient had a slight euphoria.An EEG recording showed a continuous regional EEG-seizure pattern. In combination with the clinical symptoms we diagnosed a nonconvulsive status epilepticus. Under anticonvulsive treatment with Lorazepam and Valproic acid the status epilepticus sustended but a control EEG recording showed signs of a Valproate-encephalopathy. Under treatment with Topiramate symptoms ameliorated but due to a vascular dementia the patient still showed fluctuating symptoms of cognitive and mnestic disturbances.
authors.affiliation: SCIVIAS St. Valentinus-Krankenhaus, Klinik für Psychiatrie, Psychotherapie und Psychosomatik Bad Soden. Sebastian-Kneipp-Straße 11, Bad Soden am Taunus. pittermann@scivias-caritas.de
authors.forename: Patrick
authors.initials: P
authors.lastname: Pittermann
authors.forename: Susanne
authors.initials: S
authors.lastname: Gabriel
authors.forename: Joachim
authors.initials: J
authors.lastname: Röschke
mesh_terms: D000339:Affect / Q000187:drug effects; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001929:Brain Edema / Q000175:diagnosis / Q000188:drug therapy; D003221:Confusion / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D003693:Delirium / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003987:Dibenzothiazepines / Q000627:therapeutic use; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D005625:Frontal Lobe / Q000187:drug effects / Q000473:pathology; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008140:Lorazepam / Q000009:adverse effects / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D009460:Neurologic Examination / Q000187:drug effects; D000069348:Quetiapine Fumarate; D012017:Referral and Consultation; D012815:Signal Processing, Computer-Assisted; D013226:Status Epilepticus / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000077236:Topiramate; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000077236:Topiramate; D000069348:Quetiapine Fumarate; D005632:Fructose; D014635:Valproic Acid; D008140:Lorazepam