Brief CommunicationRecurrent nonconvulsive status epilepticus in a patient with progressive left hemispheric leukoencephalopathy after a remote viral meningoencephalitis

- A 68-year-old female had three NCSE episodes; all triggered by UTI, with good correlation to simultaneous EEG and MRI.
- Early diagnosis is crucial to treat this potentially reversible condition.
- We presumed that infection and vaccination induced immune response triggered the epileptic foci transited from remote viral meningoencephalitis may be the main pathogenesis of this patient's recurrent NCSE.
- Recurrent NCSE is not uncommon, especially complex partial seizures with frontal lobe onset, which may be refractory to treatment and lead to permanent disability.

Nonconvulsive status epilepticus (NCSE), defined as changes in behavior and/or mental processes from baseline with continuous epileptiform discharges, remains a diagnostic and treatment challenge. Here, we present a 68-year-old female who developed 3 episodes of NCSE 10 years after a viral meningoencephalitis which gradually progressed to left hemispheric leukoencephalopathy. In this case, we hypothesize that immune-mediated mechanisms and perhaps genetic predisposition played a role in epileptogenesis, and these will be discussed.This article is part of a Special Issue entitled “Status Epilepticus”.