Non-convulsive Status Epilepticus as a Potentially Under-recognised Cause of Consciousness Disturbance Following Mechanical Thrombectomy: A Case Report.

NMC case report journal Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI:10.2176/jns-nmc.2024-0181
Kiichi Yanagisawa, Takuya Saito, Tatsuhito Ishii, Keishiro Sato, Kazunari Homma, Yoshiyuki Kondo
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Abstract

We report a case of persistent consciousness disturbance due to non-convulsive status epilepticus (NCSE) following a successful mechanical thrombectomy (MT). A 98-year-old female with atrial fibrillation presented with impaired consciousness and right hemiparesis 6 hrs after her last known well state. Magnetic resonance angiography revealed occlusion of the left internal carotid artery, necessitating MT to achieve complete recanalisation. Following admission, her consciousness showed no signs of improvement, and electroencephalography (EEG) revealed NCSE as the underlying cause. Levetiracetam treatment led to improvement in both clinical symptoms and EEG findings. This case highlights the importance of prompt diagnosis and management of NCSE in patients with ischaemic stroke who have persistent consciousness disturbance even after MT.

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非惊厥性癫痫持续状态作为机械取栓后意识障碍的潜在未被充分认识的原因:1例报告。
我们报告一例持续意识障碍由于非惊厥癫痫持续状态(NCSE)后成功的机械取栓(MT)。一位98岁女性心房颤动患者在最后一次清醒后6小时表现为意识受损和右半瘫。磁共振血管造影显示左侧颈内动脉闭塞,需要MT实现完全再通。入院后,她的意识没有改善的迹象,脑电图显示NCSE是潜在的原因。左乙拉西坦治疗可改善临床症状和脑电图结果。本病例强调了及时诊断和处理缺血性脑卒中患者NCSE的重要性,即使在MT后仍有持续的意识障碍。
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