Confirmation of nonconvulsive limbic status epilepticus with the sodium amytal test

Epilepsia. 2003 Aug;44(8):1122-6. doi: 10.1046/j.1528-1157.2003.04503.x.

Abstract

Is it a seizure? This question can be difficult for a clinician to answer, and it may be more critical if the possible seizure lasts >30 min. Long-duration questionable seizure activity changes the question to, "Is it status epilepticus?" Status epilepticus (SE) can be divided into convulsive and nonconvulsive types. Convulsive SE is the most easily recognized, whereas nonconvulsive SE is more clinically variable and controversial. The term nonconvulsive SE is more often applied to patients who are severely obtunded or comatose with minimal or no motor movements, or in a stupor of altered consciousness reflecting generalized ictal activity. Nonconvulsive SE also can be caused by focal seizure activity, sometimes restricted to deep small volumes of brain in which scalp EEG may not be diagnostic. We present the case of a patient who had dominant limbic hippocampal SE, but in whom the diagnosis could not be confirmed until a modified novel use of the sodium amytal test was performed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amobarbital*
  • Cerebral Cortex / physiopathology
  • Diffusion Magnetic Resonance Imaging
  • Dominance, Cerebral / physiology*
  • Electroencephalography*
  • Epilepsies, Partial / diagnosis*
  • Epilepsies, Partial / physiopathology
  • Female
  • Hippocampus / physiopathology*
  • Humans
  • Limbic System / physiopathology*
  • Status Epilepticus / diagnosis*
  • Status Epilepticus / physiopathology
  • Tomography, Emission-Computed, Single-Photon

Substances

  • Amobarbital