To the Editor.—
In his excellent survey, "Modern Concepts of Status Epilepticus" (235:1571, 1976), Dr Celesia quite rightly emphasizes the frequent occurrence of nonconvulsive status epilepticus manifested by episodes of confusion and impairment of consciousness. These symptoms are indeed perhaps the most frequent manifestations of nonconvulsive status epilepticus, but several studies recently published in the psychiatric literature have called attention to brief psychotic episodes of varied manifestations resulting from nonconvulsive status.1-3These clinical reports have described the abrupt onset of psychotic episodes resembling depressive, schizophrenic, and hysterical psychoses and delirium caused by status epilepticus, most commonly associated with continuous diffuse epileptiform discharges. When the patient has a history of epilepsy, the diagnosis is easily suspected, but even in adults such a history may be lacking.Four features should specifically suggest the diagnosis of psychosis due to nonconvulsive status epilepticus: (1) abrupt onset of psychosis in a patient heretofore regarded
Wells CE. Nonconvulsive Status Epilepticus. JAMA. 1976;236(7):820. doi:10.1001/jama.1976.03270080012007
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