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Nonconvulsive Status Epilepticus in Hepatic Encephalopathy

Authors
Journal
Western Journal of Emergency Medicine
1936-900X
Publisher
Western Journal of Emergency Medicine
Publication Date
Volume
12
Issue
4
Identifiers
DOI: 10.5811/westjem.2011.1.2125
Keywords
  • Clinical Practice
  • Case Report
Disciplines
  • Medicine

Abstract

We discuss a case of a 64-year-old male with a history of liver failure presenting with altered mental status, initially diagnosed with hepatic encephalopathy but ultimately diagnosed with nonconvulsive status epilepticus (NCSE) by electroencephalogram (EEG). NCSE is a difficult diagnosis to make, given no clear consensus on diagnostic criteria. Especially in the intensive care unit setting of persistent altered mental status with no clear etiology, NCSE must be considered in the differential diagnosis, as the consequences of delayed diagnosis and treatment can be substantial. EEG can be useful in the evaluation of patients with hepatic encephalopathy who have persistently altered levels of consciousness despite optimal medical management.

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