title: Differential diagnosis by EEG of dissociative status versus nonconvulsive status epilepticus.
abstract: BACKGROUND
  Nonconvulsive status epilepticus (NCSE) has different clinical presentations, from minimal confusion to bizarre behavioral manifestations, psychosis or coma. As a result, patients can sometimes be misdiagnosed and labeled as psychiatric cases.
  
  
  METHODS
  The patient was alert and disoriented in time, with disconnection episodes, generalized slowness, slow mental response, faltering language and slow answers. A differential diagnosis between dissociative status and NCSE was proposed. The physical and neurological examinations were normal. The cranial CT scan findings were normal. Only the EEG provided the definitive diagnostic data, consisting of generalized spike and wave discharges of 2-3 Hz against a desynchronized background.
  
  
  CONCLUSIONS
  Diagnosis of NCSE requires the availability of an EEG. Often patients are on the border between medical conditions and mental disorders. Observation of the disease evolution and an open-minded attitude of physicians are necessary for the correct diagnosis and treatment.
authors.affiliation: Psychiatry Department, Hospital Universitario de Guadalajara, Spain. caumsz@yahoo.es
authors.forename: Carlos
authors.initials: C
authors.lastname: Amo
authors.forename: Nélida
authors.initials: N
authors.lastname: Elices
authors.forename: David
authors.initials: D
authors.lastname: Huertas
mesh_terms: D003937:Diagnosis, Differential; D004213:Dissociative Disorders / Q000175:diagnosis*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008875:Middle Aged; D013226:Status Epilepticus / Q000175:diagnosis*