Nonconvulsive status epilepticus (NCSE) is characterized by persistent change in mental status from baseline lasting more than 5 minutes, generally with epileptiform activity seen on EEG monitoring and subtle or no motor abnormalities. NCSE can be a difficult diagnosis to make in the emergency department setting, but the key to diagnosis is a high index of suspicion coupled with rapid initiation of continuous EEG and early involvement of neurology.

Nonconvulsive status epilepticus (NCSE) presents with persistent alteration in behavior or consciousness without convulsions, though subtle motor signs such as twitching or blinking may be present.

There are 3 categories of NCSE: simple partial status epilepticus, complex partial status epilepticus, and absence status epilepticus.

The only symptom seen consistently in NCSE is altered mental status, which can range from mild confusion to obtundation.

NCSE often remains undiagnosed by psychiatrists and emergency clinicians due to failure to consider the diagnosis and lack of emergent electroencephalography (EEG).

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