Estatus epiléptico no convulsivo en Unidad de Cuidados Intensivos: Reporte de caso

Abstract

BACKGROUND: Status epilepticus is considered an essential public health problem with high morbidity and mortality. One subtype is non-convulsive status epilepticus, considered a medical emergency that presents high variability in its clinical manifestations and difficulty in diagnosis. Some underlying medical conditions, such as brain injuries, cerebrovascular disorders, and metabolic disorders, can increase the risk of this pathology, constituting approximately 20% of all cases of status epilepticus in patients in general hospitals. CASE PRESENTATION: An 88-year-old female patient with a record of high blood pressure, heart failure, and diabetes mellitus presented with an altered state of consciousness due to a fall while standing, suffering an impact in the right region against a hard surface. After the analysis, the tomography revealed an acute subdural hematoma, and a craniotomy was performed afterward. On the second day of admission to the intensive care unit, the patient did not show post-surgical clinical improvement, and the sign of clonus was identified. Therefore, an electroencephalogram was performed, diagnosing non-convulsive status epilepticus. After nine days of treatment and clinical management, the evolution was poor, and the patient passed away. EXPECTED CONCLUSIONS: Non-convulsive status epilepticus is a pathology with varied clinical manifestations and whose definitive diagnosis is based on the electroencephalogram. Adequate management is essential to prevent complications and improve the general well-being of those who experience this state.