Use of Headset Electroencephalogram for Differentiating Non-Convulsive Status Epilepticus from Hyperacute Stroke following Subcortical Hemorrhage

Abstract

A 72-year-old woman presented with sensory aphasia and left-sided hemiparesis. Brain MRI revealed cortical hyperintensities in the right MCA territory on both DWI and FLAIR sequences. MRA showed no evidence of large-vessel occlusion. To differentiate non-convulsive status epilepticus (NCSE) from acute ischemic stroke, we performed a headset electroencephalogram (HS-EEG), which demonstrated rhythmic slow waves at 1.5–2 Hz predominantly over the right hemisphere. Based on these findings, a diagnosis of NCSE was made. HS-EEG may serve as a valuable tool for distinguishing NCSE from acute stroke in cases where conventional imaging is inconclusive.