Non-convulsive Status Epilepticus as a Potentially Under-recognised Cause of Consciousness Disturbance Following Mechanical Thrombectomy: A Case Report

Abstract

We report a case of persistent consciousness disturbance due to non-convulsive status epilepticus (NCSE) following a successful mechanical thrombectomy (MT). A 98-year-old female with atrial fibrillation presented with impaired consciousness and right hemiparesis 6 hrs after her last known well state. Magnetic resonance angiography revealed occlusion of the left internal carotid artery, necessitating MT to achieve complete recanalisation. Following admission, her consciousness showed no signs of improvement, and electroencephalography (EEG) revealed NCSE as the underlying cause. Levetiracetam treatment led to improvement in both clinical symptoms and EEG findings. This case highlights the importance of prompt diagnosis and management of NCSE in patients with ischaemic stroke who have persistent consciousness disturbance even after MT.