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Altered Mental Status-Does Your Patient Have Non-Convulsive Status Epilepticus?
Ever intubated a patient in status epilepticus and wondered if they were still seizing after sedation and paralysis? Ever taken care of an altered patient and wondered if you should consult neurology and attempt to get an EEG?
NCSE is defined as continuous seizure activity without obvious outward manifestations of a seizure. This is important for emergency physicians to consider because it has to be detected early to prevent morbidity and mortality.
When to consider NCSE:
- Prolonged postictal period
- Unexplained altered mental status in a patient with a history of seizures
- Altered mental status associated with "eye twitching" or blinking
- Stroke patient who clinically looks worse than expected