title: Rapidly progressive cognitive impairment with neuropsychiatric symptoms as the initial manifestation of status epilepticus.
abstract: The purpose of this article is to describe the clinical and electroencephalographic features of patients diagnosed with non-convulsive status epilepticus (NCSE) with uncommon cognitive and behavioral involvement. We present two cases with sub-acute cognitive impairment and neuropsychiatric disorders (including anxiety and transient behavioral changes) as their first manifestation of NCSE. A neuropsychological profile demonstrated executive dysfunction. In addition, the neurological examination revealed automatisms and 24-hour video EEG showed epileptiform activity. Although neuroimaging studies showed frontotemporal abnormalities, both neurophysiological and cognitive improvement after specific antiseizure drug treatment confirmed the diagnosis of non-convulsive status. Theoretical considerations between mental status changes and focal epilepsy will be reviewed. Our cases raise awareness of the importance of considering NCSE, a treatable condition, in the differential diagnosis of rapidly-progressive cognitive impairment with neuropsychiatric symptoms.
authors.affiliation: Neurology Department, Fundación CardioInfantil, Hospital Universitario Mayor, University of Rosario, Bogotá, Colombia.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Mutis
authors.affiliation: Neurology Department, Fundación CardioInfantil, Hospital Universitario Mayor, University of Rosario, Bogotá, Colombia.
authors.forename: Jesús H
authors.initials: JH
authors.lastname: Rodríguez
authors.affiliation: Neuroscience Research Group (NEUROS), University of Rosario, Bogotá, Colombia.
authors.forename: Mauricio O
authors.initials: MO
authors.lastname: Nava-Mesa
keywords: Behavior changes; Cognitive impairment; Epilepsy; Non-convulsive status epilepticus