Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern

Objective. We are reporting two cases: a patient with steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) and another patient with secondary progressive multiple sclerosis (SPMS), both presenting with altered mental status (AMS) and later diagnosed with nonconvulsive aty...

Full description

Saved in:
Bibliographic Details
Main Authors: Channaiah Srikanth Mysore, Najib Murr, Rana Zabad, John Bertoni
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2017/6987821
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832564025073860608
author Channaiah Srikanth Mysore
Najib Murr
Rana Zabad
John Bertoni
author_facet Channaiah Srikanth Mysore
Najib Murr
Rana Zabad
John Bertoni
author_sort Channaiah Srikanth Mysore
collection DOAJ
description Objective. We are reporting two cases: a patient with steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) and another patient with secondary progressive multiple sclerosis (SPMS), both presenting with altered mental status (AMS) and later diagnosed with nonconvulsive atypical absence status epilepticus (AS), with atypical EEG changes. Methods. A report of two cases. Results. A patient with history of SREAT and the other with SPMS had multiple admissions due to AMS. For both, EEG revealed the presence of a high voltage generalized sharply contoured theta activity. A diagnosis of NCSE with clinical features of AS was made based on both clinical and EEG features. There was significant clinical and electrographic improvement with administration of levetiracetam for both patients in addition to sodium valproate and Solumedrol for the SREAT patient. Both patients continued to be seizure free on follow-up few months later. Conclusions. This is a report of two cases of atypical AS, with atypical EEG, in patients with different neurological conditions. Prompt clinical and EEG recovery occurred following appropriate medical treatment. We think that this condition might be underreported and could significantly benefit from prompt treatment when appropriately diagnosed.
format Article
id doaj-art-f797d8a8f96a478ab405390eb8e8f1ae
institution Kabale University
issn 2090-6668
2090-6676
language English
publishDate 2017-01-01
publisher Wiley
record_format Article
series Case Reports in Neurological Medicine
spelling doaj-art-f797d8a8f96a478ab405390eb8e8f1ae2025-02-03T01:12:07ZengWileyCase Reports in Neurological Medicine2090-66682090-66762017-01-01201710.1155/2017/69878216987821Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG PatternChannaiah Srikanth Mysore0Najib Murr1Rana Zabad2John Bertoni3Department of Neurological Sciences, University of Nebraska Medical Center, 988440 Nebraska Medical Center, Omaha, NE 68198-8440, USADepartment of Neurology, Southern Illinois University School of Medicine, 751 N Rutledge Street, Springfield, IL 62794, USADepartment of Neurological Sciences, University of Nebraska Medical Center, 988440 Nebraska Medical Center, Omaha, NE 68198-8440, USADepartment of Neurological Sciences, University of Nebraska Medical Center, 988440 Nebraska Medical Center, Omaha, NE 68198-8440, USAObjective. We are reporting two cases: a patient with steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) and another patient with secondary progressive multiple sclerosis (SPMS), both presenting with altered mental status (AMS) and later diagnosed with nonconvulsive atypical absence status epilepticus (AS), with atypical EEG changes. Methods. A report of two cases. Results. A patient with history of SREAT and the other with SPMS had multiple admissions due to AMS. For both, EEG revealed the presence of a high voltage generalized sharply contoured theta activity. A diagnosis of NCSE with clinical features of AS was made based on both clinical and EEG features. There was significant clinical and electrographic improvement with administration of levetiracetam for both patients in addition to sodium valproate and Solumedrol for the SREAT patient. Both patients continued to be seizure free on follow-up few months later. Conclusions. This is a report of two cases of atypical AS, with atypical EEG, in patients with different neurological conditions. Prompt clinical and EEG recovery occurred following appropriate medical treatment. We think that this condition might be underreported and could significantly benefit from prompt treatment when appropriately diagnosed.http://dx.doi.org/10.1155/2017/6987821
spellingShingle Channaiah Srikanth Mysore
Najib Murr
Rana Zabad
John Bertoni
Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern
Case Reports in Neurological Medicine
title Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern
title_full Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern
title_fullStr Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern
title_full_unstemmed Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern
title_short Nonconvulsive Status Epilepticus Resembling Clinical Absence with Atypical EEG Pattern
title_sort nonconvulsive status epilepticus resembling clinical absence with atypical eeg pattern
url http://dx.doi.org/10.1155/2017/6987821
work_keys_str_mv AT channaiahsrikanthmysore nonconvulsivestatusepilepticusresemblingclinicalabsencewithatypicaleegpattern
AT najibmurr nonconvulsivestatusepilepticusresemblingclinicalabsencewithatypicaleegpattern
AT ranazabad nonconvulsivestatusepilepticusresemblingclinicalabsencewithatypicaleegpattern
AT johnbertoni nonconvulsivestatusepilepticusresemblingclinicalabsencewithatypicaleegpattern