Association between electrographic seizures and better neurological functional outcomes in non-convulsive status epilepticus.

OBJECTIVE In non-convulsive status epilepticus (NCSE), predicting patient outcomes is crucial in deciding treatment intensity. However, electroencephalograms (EEGs) of NCSE show various patterns, and their relationship with functional outcomes remains unclear. We aimed to examine the relationship between NCSE EEG patterns and functional outcomes. METHODS We retrospectively collected data from 105 NCSE patients without cardiopulmonary arrest at two centers and compared functional outcomes in NCSE patients with electrographic seizures (ESz) and those with rhythmic/periodic patterns (RPPs) at discharge. Functional outcomes were assessed using the dichotomized modified Rankin scale (≥4 or less), with univariate and multivariate analyses conducted on patient backgrounds and therapeutic interventions. We compared background activities and discharge waveforms in periodic discharges (PDs) using the Fourier transform. RESULTS ESz independently predicted better outcomes after adjusting for severity (Glasgow Coma Scale and Epidemiology-based Mortality Score). In PDs, the group with better outcomes exhibited larger alpha-band background activity and larger post-discharge slow waves. CONCLUSIONS NCSE with ESz was associated with better functional outcomes than RPPs alone. Spared alpha-band background activity and larger amplitude of post-discharge slow shifts may indicate spared brain function in patients with PDs. SIGNIFICANCE These results could assist in predicting outcomes and deciding treatment intensity in NCSE.

• Publication year

  2025

• Venue

  Seizure

• Publication date

  2025-12-26

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/j.seizure.2025.12.014PMID 41475063
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Focal nonconvulsive status epilepticus with impaired consciousness in older adults: Prognosis-related variables.

  2023cited by this paper
• Prognostic value of Salzburg nonconvulsive status epilepticus criteria: The SACE score

  2023cited by this paper
• Neuroprognostication: a conceptual framework

  2022cited by this paper
• Salzburg consensus criteria are associated with long-term outcome after non-convulsive status epilepticus.

  2022cited by this paper
• Not all rhythmicities and periodicities in coma electroencephalography are fatal—When simplification becomes dangerous

  2022cited by this paper
• Clinical phenotypes within nonconvulsive status epilepticus

  2021cited by this paper
• Cortical and thalamic hyper-perfusion in non-convulsive status epilepticus. Relationship between perfusion CT patterns and Salzburg EEG criteria.

  2021cited by this paper
• De-novo non-convulsive status epilepticus in adult medical inpatients without known epilepsy: Analysis of mortality related factors and literature review

  2021cited by this paper
• Elderly patients with nonconvulsive status epilepticus: Clinical-EEG data, hospital mortality, STESS and EMSE.

  2021cited by this paper
• Alpha-power in electroencephalography as good outcome predictor for out-of-hospital cardiac arrest survivors

  2021cited by this paper
• American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2021 Version.

  2021cited by this paper
• Will MRI replace the EEG for the diagnosis of nonconvulsive status epilepticus, especially focal?

  2021cited by this paper
• Lateralized Periodic Discharges: Which patterns are interictal, ictal, or peri-ictal?

  2021cited by this paper
• Electrical cortical stimulations modulate spike and post-spike slow-related high-frequency activities in human epileptic foci.

  2020cited by this paper
• Electroclinical patterns in patients with nonconvulsive status epilepticus: Etiology, treatment, and outcome.

  2020cited by this paper
• The role of electroencephalography in the early diagnosis of non-convulsive status epilepticus in elderly patients with acute confusional state: Two possible strategies?

  2019cited by this paper
• Peri-ictal magnetic resonance imaging in status epilepticus: Temporal relationship and prognostic value in 60 patients.

  2019cited by this paper
• Nonconvulsive seizures and nonconvulsive status epilepticus in the neuro ICU should or should not be treated aggressively: A debate

  2019cited by this paper
• Reevaluation of the Critically Ill Patients With Nonconvulsive Status Epilepticus by Using Salzburg Consensus Criteria

  2018cited by this paper
• Continuous EEG monitoring in ICU

  2018cited by this paper
• Nonconvulsive status epilepticus after convulsive status epilepticus: Clinical features, outcomes, and prognostic factors.

  2018cited by this paper
• The electroclinical spectrum, etiologies, treatment and outcome of nonconvulsive status epilepticus in the elderly.

  2018cited by this paper
• Chloride Dysregulation, Seizures, and Cerebral Edema: A Relationship with Therapeutic Potential.

  2017cited by this paper
• Clinical outcomes in patients with generalized periodic discharges.

  2017cited by this paper
• Status epilepticus: Clinical characteristics and EEG patterns associated with and without MRI diffusion restriction in 69 patients.

  2016cited by this paper
• Status epilepticus in the elderly: Prognostic implications of rhythmic and periodic patterns in electroencephalography and hyperintensities on diffusion-weighted imaging.

  2016cited by this paper
• Sleep modulates cortical connectivity and excitability in humans: Direct evidence from neural activity induced by single‐pulse electrical stimulation

  2015cited by this paper
• A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus

  2015cited by this paper
• Adult nonconvulsive status epilepticus in a clinical setting: Semiology, aetiology, treatment and outcome.

  2015cited by this paper
• Which EEG patterns in coma are nonconvulsive status epilepticus?

  2015cited by this paper
• Non-convulsive Status Epilepticus and Non-convulsive Seizures in Neurological ICU Patients

  2015cited by this paper
• Epidemiology-Based Mortality Score in Status Epilepticus (EMSE)

  2015cited by this paper
• Enhanced slow waves at the periphery of human epileptic foci.

  2015cited by this paper
• Etiology and prognosis of non-convulsive status epilepticus.

  2014cited by this paper
• Preictal surrender of post–spike slow waves to spike‐related high‐frequency oscillations (80–200 Hz) is associated with seizure initiation

  2014cited by this paper
• Prevalence of non-convulsive seizure and other electroencephalographic abnormalities in ED patients with altered mental status.

  2013cited by this paper

• No citing papers are available for this paper.