Non convulsive status epilepticus in the elderly

Non-convulsive status epilepticus (NCSE) is common in the elderly. It most often corresponds to prolonged focal seizures with impaired contact ("complex partial status epilepticus"). A form of de novo absence status epilepticus, much rarer, can also meet. The identified risk factors for NCSE onset are: a precession by a generalized tonic-clonic seizure, a known history of epilepsy, female gender, and known brain injury (especially a stroke sequelae). The presence of one of these risk factors combined with a confusional picture of unknown origin should lead us to think of the diagnosis of NCSE. As the clinic is often not very suggestive (stupor, confusion, even coma), the diagnosis will be based on the EEG with criteria now accepted (so-called Salzburg EEG criteria). The treatment is based first on the injection of benzodiazepines and in the second line on intravenous or oral or gastric tube administration of antiepileptic drugs. It is not recommended to resort to an intubation-ventilation (except need out treatment of the state of evil: respiratory distress, multi-organ failure ...). The prognosis is generally poor with about 30% mortality.