The Journal of the Society of Stroke on Korean Medicine (대한중풍순환신경학회지)

The Society of Stroke on Korean Medicine (대한중풍순환신경학회)
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A Case of Nonconvulsive Status Epilepticus Patient Complaining Delirium Treated with Combined Korean Medical Treatment

섬망을 호소하는 비경련성 간질 중첩증 환자에 대한 복합 한의치험 1례

  • Dabin, Lee (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Ho Jung, Park (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Youngseon, Lee (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Ki-Ho, Cho (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Sang-Kwan, Moon (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Woo-Sang, Jung (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Seungwon, Kwon (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Han-Kyul, Lee (Dept. of Cardiology and Neurology, College of Korean medicine, Kyung-Hee University)
  • 이다빈 (경희대학교 대학원 임상한의학과) ;
  • 박호정 (경희대학교 대학원 임상한의학과) ;
  • 이영선 (경희대학교 대학원 임상한의학과) ;
  • 조기호 (경희대학교 대학원 임상한의학과) ;
  • 문상관 (경희대학교 대학원 임상한의학과) ;
  • 정우상 (경희대학교 대학원 임상한의학과) ;
  • 권승원 (경희대학교 대학원 임상한의학과) ;
  • 이한결 (경희대학교 한의과대학 순환신경내과학교실)
  • Published : 2022.12.01
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Abstract

Nonconvulsive Status Epilepticus(NCSE) refers to continuous epileptic condition with altered mental status and behavioral symptoms, but without convulsive movement at least 10 minutes. In Salzburg criteria, well known as the diagnostic criteria of NCSE, it is diagnosed with clinical symptoms, electroencephalogram (EEG), and effects before and after the use of antiepileptic drugs (AEDs). Commonly being used to treat NCSE, AEDs are likely to have adverse effects. In the present case, a 85-year-old female NCSE patient complaining delirium underwent combined Korean medical treatment by acupuncture and herbal medicine for 13 days. The effect of treatment was assessed with delirium scales including Delirium Rating Scale-Revised-98(DRS-R-98) and Assessment Test for Delirium & Cognitive Impairment(4AT) per 2 days. After the treatment, both DRS-R-98 and 4AT scores decreased, and orientation and mental status of patient improved. This case report suggests that Korean medical treatment might be an effective option without side for those NCSE patients complaining delirium.

Keywords

References

  1. San-Juan D, Angeles EB, Gonzalez-Aragon M  del CF, et al. Nonconvulsive Status Epilepticus:  Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico. Journal  of Clinical Neurophysiology. 2022;Publish  Ahead of Print. 
  2. Trinka E, Cock H, Hesdorffer D, et al. A  definition and classification of status epilepticus - Report of the ILAE Task Force on  Classification of Status Epilepticus. Epilepsia.  2015;56(10):1515-1523.  https://doi.org/10.1111/epi.13121
  3. Leitinger M, Trinka E, Zimmermann G,  Beniczky S. Salzburg criteria for nonconvulsive status epilepticus: Details matter. Epilepsia. 2019;60(11):2334-2336.  https://doi.org/10.1111/epi.16361
  4. Mulkerrin P, Gopinathan D, O'Keeffe ST.  Challenge of diagnosing non-convulsive status  epilepticus presenting as delirium. Eur Geriatr  Med. 2018;9(5):721-724.  https://doi.org/10.1007/s41999-018-0092-9
  5. Drislane FW. Presentation, Evaluation, and  Treatment of Nonconvulsive Status Epilepticus. Epilepsy & Behavior. 2000;1(5):301-314  https://doi.org/10.1006/ebeh.2000.0100
  6. Kaplan PW. The Clinical Features, Diagnosis,  and Prognosis of Nonconvulsive Status Epilepticus. The Neurologist. 2005;11(6):348-361.  https://doi.org/10.1097/01.nrl.0000162954.76053.d2
  7. Cole M, Shen J, Hommer D. Convulsive  Syncope Associated with Acupuncture. The  American Journal of the Medical Sciences.  2002;324(5):288-289. 
  8. Jin HB, Li B, Cu J, Cheng JS, Yang R. ELECTRO-ACUPUNCTURE IMPROVES EPILEPTIC SEIZURES INDUCED BY KAINIC  ACID IN TAURINE-DEPLETION RATS. acupunct electrother res. 2005;30(3):207-217.  https://doi.org/10.3727/036012905815901280
  9. Leitinger M, Trinka E, Zimmermann G,  Beniczky S. Salzburg criteria for nonconvulsive status epilepticus: Details matter. Epilepsia. 2019;60(11):2334-2336.  https://doi.org/10.1111/epi.16361
  10. The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. BMC  Med. 2014;12(1). doi:10.1186/s12916-014-0141-2 
  11. 최수정, 조용애. CAM-ICU로 평가한 중환자실의 섬망 발생률과섬망 발생 위험요인. Journal of Korean Clinical Nursing Research. 2014;20(3):406-416. doi:10.22650/JKCNR.2014.20.3.406 
  12. Gower L, Gatewood M, Kang C. Emergency  Department Management of Delirium in the  Elderly. WestJEM. 2012;13(2):194-201.  https://doi.org/10.5811/westjem.2011.10.6654
  13. Annalee MB, Matthew AY, Navid RA. Nonconvulsive status epilepticus: overlooked and  undertreated. Emerg Med Pract. 2019;21(10):1-24. 
  14. Liang P, Wang Z, Qian T, Li K. Acupuncture  Stimulation of Taichong (Liv3) and Hegu (LI4)  Modulates the Default Mode Network Activity  in Alzheimer's Disease. Am J Alzheimers Dis  Other Demen 
  15. HWANG IK, CHUNG JY, YOO DY, et al. Comparing the Effects of Acupuncture and Electroacupuncture at Zusanli and Baihui on Cell Proliferation and Neuroblast Differentiation in the Rat Hippocampus.
  16. Dai XJ, Min YJ, Gong HH, Gao L, Wang SY,  Zhou FQ, Xiao XZ, Liu BX. [Evaluation of  the post-effect of acupuncture at Sanyinjiao (SP  6) under sleep deprivation by resting-state amplitude of low-frequency fluctuation: a fMRI  study]. Zhongguo Zhen Jiu. 2012 Jan;32(1):47-52. 
  17. Trzepacz PT, Mittal D, Torres R, Kanary  K, Norton J, Jimerson N. Validation of the  Delirium Rating Scale-Revised-98. JNP.  2001;13(2):229-242.  https://doi.org/10.1176/jnp.13.2.229
  18. Todd OM, Teale EA. Delirium: a guide for the  general physician. Clin Med. 2017;17(1):48-53. doi:10.7861/clinmedicine.17-1-48 
  19. Laccheo I, Sonmezturk H, Bhatt AB, et  al. Non-convulsive Status Epilepticus and  Non-convulsive Seizures in Neurological ICU  Patients. Neurocrit Care. 2014;22(2):202-211.  https://doi.org/10.1007/s12028-014-0070-0
  20. Zehtabchi S, Abdel Baki SG, Omurtag A, et  al. Prevalence of non-convulsive seizure and  other electroencephalographic abnormalities  in ED patients with altered mental status. The  American Journal of Emergency Medicine.  2013;31(11):1578-1582. 
  21. Brophy GM, Bell R, et al. Guidelines for the  Evaluation and Management of Status Epilepticus. Neurocrit Care. 2012;17(1):3-23.  doi:10.1007/s12028-012-9695-z 
  22. Sutter R, Kaplan PW. Electroencephalographic criteria for nonconvulsive status epilepticus: Synopsis and comprehensive survey.  Epilepsia. 2012;53:1-51. doi:10.1111/j.1528-1167.2012.03593.x 
  23. Walker M, Cross H, Smith S, et al. Nonconvulsive status epilepticus: Epilepsy Research  Foundation workshop reports. Epileptic Disord. 2005;7(3):253-96. 
  24. Hopp JL, Sanchez A, Krumholz A, Hart  G, Barry E. Nonconvulsive Status Epilepticus. The Neurologist. 2011;17(6):325-329.  doi:10.1097/nrl.0b013e31822f688c 
  25. 相見三郎, 斉藤隆, 松田健身. The Effect of  Saiko-Keishi-to on the Treatment of Epilepsy, Referring to the Improvement of th  Electroencephalogram of Them. 日本東洋醫學會誌. 1976;27:99-116. doi:10.14868/kampomed1950.27.3_99 
  26. Miyaoka T, Furuya M, Yasuda H, Hayashia  M, Inagaki T, Horiguchi J. Yi-gan san for  the treatment of borderline personality disorder: An open-label study. Progress in  Neuro-Psychopharmacology and Biological  Psychiatry. 2008;32(1):150-154. doi:10.1016/j.pnpbp.2007.07.026 
  27. Monji A, Takita M, Samejima T, et al. Effect  of yokukansan on the behavioral and psychological symptoms of dementia in elderly  patients with Alzheimer's disease. Progress in  Neuro-Psychopharmacology and Biological  Psychiatry. 2009;33(2):308-311 
  28. Shinno H, Inami Y, Inagaki T, Nakamura Y, Horiguchi J. Effect of Yi-Gan San on  psychiatric symptoms and sleep structure at  patients with behavioral and psychological  symptoms of dementia. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2008;32(3):881-885. doi:10.1016/j.pnpbp.2007.12.027