Non-convulsive status epilepticus (NCSE): electroencephalogram (EEG)

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Non-convulsive status epilepticus (NCSE): electroencephalogram (EEG). Low level of consciousness. Fully referenced neurology checklist.

Indications for urgent EEG

  • Low level of consciousness
  • Absence of recent seizure risk factors
  • Recent tonic clonic activity
  • Abnormal motor movement
  • History of epilepsy
  • Abnormal eye movements: nystagmus, hippus, or sustained eye deviation
  • Remote seizure risk factors: stroke, brain tumours, or previous neurosurgery

EEG types

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Typical EEG features

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Possible (borderline) EEG features

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EEG features of coma not suggestive of NCSE

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EEG diagnostic criteria for NCSE

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References

  1. Chan J-L, Ross ED. Left-handed mirror writing following right anterior cerebral artery infarction: evidence for nonmirror transformation of motor programs by right supplementary motor area. Neurology 1988; 38:59-63.
  2. Kaplan PW. EEG criteria for nonconvulsive status epilepticus. Epilepsia 2007; 48(Suppl 8):39-41. 
  3. Trinka E, Leitinger M. Which EEG patterns in coma are nonconvulsive status epilepticus? Epilepsy Behav 2015; 49:203-22. 
  4. Leitinger M, Beniczky S, Rohracher A, et al. Salzburg consensus criteria for non-convulsive status epilepticus-approach to clinical application. Epilepsy Behav 2015; 49:158-163.
  5. Leitinger M, Trinka E, Gardella E, et al. Diagnostic accuracy of the Salzburg EEG criteria for non-convulsive status epilepticus: a retrospective study. Lancet Neurol 2016; 15:1054-1062.
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