Nonconvulsive Status Epilepticus in Terminally Ill Patients—A Diagnostic and Therapeutic Challenge Stefan Lorenzl, MD, Simon Mayer, MD, Soheyl Noachtar,

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Presentation transcript:

Nonconvulsive Status Epilepticus in Terminally Ill Patients—A Diagnostic and Therapeutic Challenge Stefan Lorenzl, MD, Simon Mayer, MD, Soheyl Noachtar, MD, Gian Domenico Borasio, MD Journal of Pain and Symptom Management Volume 36, Issue 2, Pages 200-205 (August 2008) DOI: 10.1016/j.jpainsymman.2007.10.006 Copyright © 2008 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 1 Figure shows parts of the EEG of the two patients described in the case reports. In Case 1, frontal epileptic activity is seen, and in Case 2, left temporal spike wave complexes indicate seizure activity. Journal of Pain and Symptom Management 2008 36, 200-205DOI: (10.1016/j.jpainsymman.2007.10.006) Copyright © 2008 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 2 Figure illustrates the stepwise treatment options of NCSE of terminally ill patients. The first step includes benzodiazepines and phenytoin, followed in the next step with valproic acid. Midazolam might be given in both steps. The third step consists of lidocaine and levetiracetam, which can be given in addition to valproic acid. The time gap between steps should not be more than 24–48 hours. Journal of Pain and Symptom Management 2008 36, 200-205DOI: (10.1016/j.jpainsymman.2007.10.006) Copyright © 2008 U.S. Cancer Pain Relief Committee Terms and Conditions