Identifying Non-Convulsive Status Epilepticus

Non-convulsive status epilepticus can be a challenging diagnosis in the ED, occurring in up to 50% of patients with coma or convulsive status. The condition involves ongoing or intermittent seizure activity without convulsions lasting over 10 minutes. Signs like sustained eye deviation, nystagmus, lip smacking, and subtle motor twitches may indicate non-convulsive status. Specificity of ocular movement abnormalities in diagnosing non-convulsive status can exceed 80%, making them crucial indicators to consider.