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Rapidly progressive cognitive impairment with neuropsychiatric symptoms as the initial manifestation of status epilepticus

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Mutis, Jorge A.
Rodríguez, Jesús H.
Nava Mesa, Mauricio Orlando

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2017

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Abstract
The purpose of this article is to describe the clinical and electroencephalographic features of patients diagnosed with non-convulsive status epilepticus (NCSE) with uncommon cognitive and behavioral involvement. We present two cases with sub-acute cognitive impairment and neuropsychiatric disorders (including anxiety and transient behavioral changes) as their first manifestation of NCSE. A neuropsychological profile demonstrated executive dysfunction. In addition, the neurological examination revealed automatisms and 24-hour video EEG showed epileptiform activity. Although neuroimaging studies showed frontotemporal abnormalities, both neurophysiological and cognitive improvement after specific antiseizure drug treatment confirmed the diagnosis of non-convulsive status. Theoretical considerations between mental status changes and focal epilepsy will be reviewed. Our cases raise awareness of the importance of considering NCSE, a treatable condition, in the differential diagnosis of rapidly-progressive cognitive impairment with neuropsychiatric symptoms. © 2016 The Authors
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Behavior Changes , Cognitive Impairment , Epilepsy , Non-Convulsive Status Epilepticus
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