Abstract：
Febrile status epilepticus evolves from a febrile seizure (FS) in 5% of cases. Its prompt recognition is challenging, especially when motor manifestations are absent or subtle. We describe the ictal electroclinical features of non-convulsive febrile status epilepticus (NCFSE) following an apparently concluded FS, initially misinterpreted as postictal obtundation and in some way mimicking the described \"non-epileptic twilight state\". We present an electroclinical study of 18 children, collected in our unit, who presented with NCFSE after an apparently resolved FS, longitudinally followed for one year to seven years and nine months (mean: four years and three months). The age at first NCFSE ranged between one year and two months and five years and eight months (mean: two years and six months). Patients were examined after spontaneous or rectal diazepam-induced resolution of a FS, while showing persisting impairment of awareness. A lack of responsiveness to painful stimulation, abnormal posturing and aphasia were present in all cases, variably associated with perioral cyanosis, hypersalivation, automatisms, gaze deviation and other lateralizing signs; eyes were open. The EEG recording started 20 to 140 minutes after the apparent resolution of the FS and was invariably characterized by delta or theta-delta pseudorhythmic activity, mainly involving the fronto-temporal regions, with hemispheric predominance in two thirds of the cases. The electroclinical condition, lasting 25 to 210 minutes, quickly recovered after intravenous diazepam. Follow-up revealed normal neurodevelopment and EEG in almost all patients (learning disability emerged in three). In five subjects, NCSE relapsed (twice in two). None presented afebrile seizures. Our series highlights the electroclinical features of focal NCFSE. Distinctive elements are a lack of reactivity, cyanosis, lateralizing clinical and EEG signs, and resolution clearly tied to intravenous benzodiazepine administration.
摘要：
在5％的病例中，癫痫持续状态由高热性癫痫（FS）演变而来。它的迅速识别具有挑战性，特别是当运动表现不存在或微妙时。我们描述了非惊厥性高热性癫痫持续状态（NCFSE）的发作电临床特征，最初被误解为后位弱化，并在某种程度上模仿了所描述的“非癫痫性暮光状态”。我们对18名儿童进行了临床电研究，收集在我们单位，在一个明显解决的FS之后，他向NCFSE提出了意见，纵向随访1年至7年零9个月(平均:4年零3个月).第一次NCFSE的年龄介于1岁和2个月以及5岁和8个月之间（平均：2岁和6个月）。患者在自发性或直肠地西泮诱导的FS消退后进行检查，同时表现出持续的意识障碍。对痛苦的刺激缺乏反应，所有病例均存在异常姿势和失语症，与口周紫癜相关，唾液分泌过多,自动机，视线偏离和其他偏侧迹象；眼睛睁开。脑电图记录在FS的表观分辨率后20至140分钟开始，并且总是以δ或θ-δ假节律活动为特征，主要涉及前颞区，在三分之二的病例中以半球为主。电临床状况，持续25到210分钟，静脉注射地西泮后迅速恢复。随访显示几乎所有患者的神经发育和脑电图正常（三人出现学习障碍）。在五个科目中，NCSE复发（两次）。没有人出现发热性癫痫发作。我们的系列重点介绍了局灶性NCFSE的电临床特征。独特的元素是缺乏反应性，紫癜,侧化临床和脑电图征象，和分辨率显然与静脉注射苯二氮卓类药物有关。
