title: Semiology of subtle motor phenomena in critically ill patients.
abstract: OBJECTIVE
  to investigate the semiology of subtle motor phenomena in critically ill patients, with- versus without nonconvulsive status epilepticus (NCSE).
  
  
  METHODS
  60 consecutive comatose patients, in whom subtle motor phenomena were observed in the intensive care unit (ICU), were analysed prospectively. The semiology of the subtle phenomena was described from video-recordings, blinded to all other data. For each patient, the type, location and occurrence-pattern/duration were described. EEGs recorded in the ICU were classified using the Salzburg criteria for NCSE.
  
  
  RESULTS
  only 23% (14/60) of the patients had NCSE confirmed by EEG. None of the semiological features could distinguish between patients with NCSE and those without. In both groups, the following phenomena were most common: discrete myoclonic muscle twitching and discrete tonic muscle activation. Besides these, automatisms and eye deviation were observed in both groups.
  
  
  CONCLUSIONS
  subtle motor phenomena in critically ill patients can raise the suspicion of NCSE. Nevertheless, EEG is needed to confirm the diagnosis, since none of the semiological features are specific.
authors.affiliation: Epilepsy and EEG Monitoring Center Cluj-Napoca, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Florea
authors.affiliation: Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark.
authors.forename: Simona Alexandra
authors.initials: SA
authors.lastname: Beniczky
authors.affiliation: Demed Clinics, Cluj-Napoca, Romania.
authors.forename: Helga
authors.initials: H
authors.lastname: Demény
authors.affiliation: Department of Clinical Neurophysiology, Aarhus University, Aarhus, Denmark; Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark. Electronic address: sbz@filadelfia.dk.
authors.forename: Sándor
authors.initials: S
authors.lastname: Beniczky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000503:physiopathology*; D016638:Critical Illness; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D011446:Prospective Studies; D013226:Status Epilepticus / Q000503:physiopathology; D014741:Video Recording; D055815:Young Adult
keywords: Coma; EEG; Nonconvulsive status epilepticus; Semiology