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Psychiatr Prax. 2012 May;39(4):189-92. doi: 10.1055/s-0031-1299005. Epub 2012 Apr 2.

[Delirium caused by nonconvulsive status epilepticus].

[Article in German]

Author information

  • 1SCIVIAS St. Valentinus-Krankenhaus, Klinik für Psychiatrie, Psychotherapie und Psychosomatik Bad Soden. Sebastian-Kneipp-Straße 11, Bad Soden am Taunus. pittermann@scivias-caritas.de

Abstract

We report about a patient (66 years) who was referred to our psychiatric hospital because of a progressive confusional state with acute onset. The colleagues of the referring psychiatric hospital considered a first manic episode as the cause of the symptoms and under therapy with haloperidol the confusional state had shown a progression.The clinical examination's findings were a mild central facial paresis on the right side and a mild hemiparesis on the right side with elevated reflex levels.The patient was disoriented, he had cognitive and mnestic deficits. His reasoning was slowed, incoherent and perseverating. The patient had a slight euphoria.An EEG recording showed a continuous regional EEG-seizure pattern. In combination with the clinical symptoms we diagnosed a nonconvulsive status epilepticus. Under anticonvulsive treatment with Lorazepam and Valproic acid the status epilepticus sustended but a control EEG recording showed signs of a Valproate-encephalopathy. Under treatment with Topiramate symptoms ameliorated but due to a vascular dementia the patient still showed fluctuating symptoms of cognitive and mnestic disturbances.

© Georg Thieme Verlag KG Stuttgart · New York.

PMID:
22473464
[PubMed - indexed for MEDLINE]
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