What are the signs and symptoms of status epilepticus (SE)?

Updated: Feb 13, 2018
  • Author: Julie L Roth, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

By clinical history, nonmotor simple partial status epilepticus involves subjective sensory disturbances, including the following:

  • Focal or unilateral paresthesias or numbness

  • Focal visual changes, usually characterized by flashing lights

  • Focal visual obscuration or focal colorful hallucinations

  • Olfactory or gustatory hallucinations

  • Atypical rising abdominal sensations

Epilepsy partialis continua, or focal status epilepticus of the motor cortex, may occur in various contexts, with some authors subdividing it into type I (nonprogressive) and type II (progressive).

Type I epilepsy partialis continua features include the following:

  • Intermittent, semi-rhythmic, involuntary twitching involving a discrete subset of muscles

  • Most commonly affects the face and ipsilateral distal hand musculature

  • Myoclonus of this variety may evolve into partial or generalized convulsion

Type II epilepsy partialis continua features include the following:

  • Usually linked with Rasmussen encephalitis

  • Gradual loss of unilateral function, with parallel focal or unilateral hemispheric atrophy

  • Impaired intellectual skills to various degrees

  • Possible effect on language skills

Type I complex partial status epilepticus refers to recurrent, recognizable complex partial seizures without recovery between seizures. Type II represents continuous, ongoing complex partial seizure activity. The sequence of constellation of features in complex partial status epilepticus is as follows:

  1. Serious medical, surgical, or neurologic illness

  2. A brief convulsive seizure

  3. Protracted stupor with fluctuating neurologic findings, subtle nystagmus, or focal twitching

In addition, complex partial status epilepticus may have the following characteristics:

  • History of recurrent or prolonged simple partial seizures or may follow or precede a generalized convulsive seizure

  • Confused and variable responsiveness; fluctuating or bizarre behavior

  • Impaired memory of the event

  • Clinical automatisms (eg, repetitive lip-smacking, fumbling, swallowing movements)

  • Subtle nystagmus

See Clinical Presentation for more detail.


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