Nonconvulsive status epilepticus disguising as hepatic encephalopathy

World J Gastroenterol. 2015 Apr 28;21(16):5105-9. doi: 10.3748/wjg.v21.i16.5105.

Abstract

Nonconvulsive status epilepticus has become an important issue in modern neurology and epileptology. This is based on difficulty in definitively elucidating the condition and its various clinical phenomena and on our inadequate insight into the intrinsic pathophysiological processes. Despite nonconvulsive status epilepticus being a situation that requires immediate treatment, this disorder may not be appreciated as the cause of mental status impairment. Although the pathophysiology of nonconvulsive status epilepticus remains unknown, this disorder is thought to lead to neuronal damage, so its identification and treatment are important. Nonconvulsive status epilepticus should be considered in the differential diagnosis of patients with liver cirrhosis presenting an altered mental status. We report a case of a 52-year-old male with liver cirrhosis presenting an altered mental status. He was initially diagnosed with hepatic encephalopathy but ultimately diagnosed with nonconvulsive status epilepticus by electroencephalogram.

Keywords: Electroencephalogram; Hepatic encephalopathy; Liver cirrhosis; Nonconvulsive status epilepticus.

Publication types

  • Case Reports

MeSH terms

  • Anticonvulsants / therapeutic use
  • Brain / drug effects
  • Brain / physiopathology*
  • Brain Waves / drug effects
  • Diagnostic Errors
  • Electroencephalography*
  • Fatal Outcome
  • Hepatic Encephalopathy / diagnosis*
  • Hepatic Encephalopathy / therapy
  • Hepatic Encephalopathy / virology
  • Hepatitis B / complications
  • Hepatitis B / diagnosis
  • Humans
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / therapy
  • Liver Cirrhosis / virology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Status Epilepticus / complications
  • Status Epilepticus / diagnosis*
  • Status Epilepticus / drug therapy
  • Status Epilepticus / physiopathology
  • Treatment Outcome

Substances

  • Anticonvulsants