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Yıl:2009; Cilt: 46; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2009;46(4):200-202
Diffuz Delta Dalga Frekanslı Elektriksel Aktivite Gösteren Nonkonvülzif Status Epileptikus Olgusu
A Akçalı, S Kuzudişli, M Neyal
Gaziantep Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, Gaziantep, Türkiye
Nonkonvuzif status epileptikus (NKSE), klinik olarak bilinç değişikliği ile karakterizedir ve tanı elektroensefalografi (EEG) ile konulur. Ancak günümüzde hem nörologlar hem de psikiyatristler için halen tanı sıkıntısı yaratabilmektedir. Olgumuz 53 yaşında daha öncesine ait epilepsi öyküsü olmayan ve tek bir jeneralize konvülzif nöbet sonrasında son 3 gündür devam eden anlamsız konuşma ve idrar inkontinansı sikayeti ile getirilen kadın hastaydı. NKSE ön tanısı ile çekilen EEG'si nin yaygın delta dalgaları ile karakterize olması diğer olgulardan farklı bir durum olarak gözlendi. Hastanın biyokimyasal tetkiklerinde ve kranial görüntülemelerinde patolojik bir bulguya rastlanmadı. IV benzodiazepin sonrası 12 saat içerisinde klinik ve EEG bulguları düzeldi. Herhangi bir düzeydeki şuur bozukluklarında NKSE'un akla gelmesi ve mutlaka EEG çekimi yapılması önerilir.
A Nonconvulsive Status Epilepticus Case Presenting with Diffuse Delta Wave Frequency Activity
Nonconvulsive status epilepticus (NCSE) is clinically characterized by altered mental status and the diagnosis is confirmed by electroencephalography (EEG). It may still represent a diagnostic challenge for both the neurologist and the psychiatrist. The patient was a 53 [year]-old-woman with no history of epilepsy admitted with meaningless speech and urinary incontinence lasting for 3 days after a generalized convulsive seizure. EEG recording, after the initial diagnosis of NKSE, was characterized by diffuse delta waves, which makes our case different than the other NCSE cases. Biochemical analysis and cranial images of the patient did not show any pathological changes. After 12 hours of intravenous benzodiazepine treatment, the clinical and EEG findings improved. NCSE must be suspected in case of any mental status disturbance, and EEG must be obtained.

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