Abstract
Objective: This study aimed to evaluate the feasibility and clinical outcomes of non-intubated general anesthesia (NGA) combined with continuous EEG (C-EEG) monitoring in patients with refractory non-convulsive status epilepticus (NCSE).
Methods: We retrospectively reviewed consecutive NCSE cases admitted to our institution between August 2023 and July 2024. Among these, patients with refractory NCSE who received NGA using midazolam were included. Clinical characteristics, EEG findings, diagnosis, treatment, and outcomes were analyzed. Patients were further classified into two groups based on EEG modality: those monitored with C-EEG and those monitored with routine EEG (R-EEG), and comparisons were made between the groups.
Results: A total of 38 NCSE cases were identified, of which 17 were refractory and 14 underwent NGA. The median age was 75 years, with 9 male patients. Twelve patients completed the treatment, and there were no deaths. Vital sign instability occurred in 7 patients, including one treatment discontinuation and one requiring intubation. Among the 7 C-EEG cases, seizure detection was significantly higher (71% vs. 0%), with no marked difference in clinical outcomes compared to the R-EEG group.
Conclusion: NGA for refractory NCSE appears to be feasible and safe. C-EEG monitoring during NGA may enhance seizure detection without increasing adverse events.
