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August 16, 1976

Nonconvulsive Status Epilepticus-Reply

Author Affiliations

University of Wisconsin Hospitals Center for Health Sciences Madison

JAMA. 1976;236(7):820. doi:10.1001/jama.1976.03270080012008

In Reply.—  Dr Wells emphasizes another important aspect of nonconvulsive status epilepticus—the occurrence of transient psychotic states associated with electroencephalographic evidence of continuous epileptogenic activity.The clinical manifestations of nonconvulsive status are protean and have been described as "twilight states," "confusion," "crazy behavior," "stupor," "lethargy," "delirium," and "psychosis."1,2 All these clinical presentations of altered behavior have the common feature of sudden onset. Often there is a past history of seizures or other "spells."I agree with Dr Wells that only a constant awareness of these conditions and electroencephalographic recordings during these episodes will lead to the proper diagnosis of a nonconvulsive epileptic state.