Which conditions are included in the differential diagnoses of simple partial status epilepticus (SPSE)?

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

Given the relative rarity of simple partial SE (SPSE), maintain a high degree of skepticism before considering this diagnosis. Other common processes (eg, vascular CNS insult) and other focal processes may mimic this rare entity; keep these well in mind, especially when tempted to apply increasingly risky treatment strategies. Invest more time in confirming the diagnosis and in deliberately observing the effect of each successive treatment.

The list of alternative diagnoses for SPSE is a subset of the list associated with complex partial SE (CPSE). These include the following:

  • Transient ischemia attack (TIA) and stroke

  • Migraine and its attendant neurologic phenomena (eg, sensory, visual)

  • Transient postictal phenomena analogous to Todd paresis

  • Ophthalmic disorders (eg, retinal detachment), which may mimic visual simple partial (occipital) SE

  • Peripheral neurologic syndromes and

  • Somatoform disorders

Diagnosing SPSE is understandably easiest when it arises in a patient with an established history of focal epilepsy. Evolution of SPSE from or to a clinically overt complex partial or secondarily generalized seizure also permits accurate diagnosis.

Given that confirming SPSE on clinical grounds alone may be difficult, EEG validation can be especially important. However, the yield of EEG in detecting simple partial seizure activity is variable.

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