Read story C32: Seizures without shaking (image and text)
Non-convulsive status epilepticus: an uncommon cause of ongoing confusion
Albert remains confused and poorly responsive despite initial assessment and treatment. His team considers ongoing seizure activity and arranges a recording of his brain’s electrical activity. It identifies non-convulsive status epilepticus. Some seizures occur without obvious shaking. This is an uncommon diagnostic possibility, not a reason for every person with delirium to undergo the same tests.
Story text
Panel 1. Albert remains confused and difficult to engage.
Panel 2.
- Doctor: We need to consider whether ongoing seizure activity is contributing.
Panel 3.
- Vera: But he hasn’t been shaking.
Panel 4.
- Doctor: Some seizures have no obvious shaking. An EEG, or electroencephalogram, records the brain’s electrical activity.
Panel 5.
- Neurologist: The recording shows ongoing seizure activity: non-convulsive status epilepticus.
Panel 6. Treatment stops the seizure activity. His responsiveness begins to improve.
Bottom band. Not all seizures cause shaking. Unexplained or persistent confusion may need specialist assessment.