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Chloroquine and Nonconvulsive Status Epilepticus
- Paul Mulhauser, MD;
- Yves Allemann, MD; and
- Claude Regamey, MD
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IN RESPONSE:
We thank Drs. Benbadis and Van Ness for allowing us to clarify the concept of nonconvulsive status epilepticus. This classification depends on the degree of importance given to clinical signs when defining partial complex status epilepticus and absence status. Some authors claim that it is impossible to differentiate among the various forms of nonconvulsive status epilepticus on clinical grounds [1, 2], whereas others have established criteria for precisely that purpose [3]. Furthermore, Cascino [4] defines two subgroups of complex partial status epilepticus: type I, with repeated but focal EEG alterations, and type II, with either continuous partial or secondarily generalized EEG alterations.
In our patient, EEG criteria alone were insufficient to define her type of epilepsy. Clinically, however, the patient presented with focal signs characterized by motor dysphasia and automatisms that favor a diagnosis of complex partial epilepsy [3]. The EEG results were compatible with the generalized phase of type II complex partial status epilepticus. We excluded the diagnosis of absence status on clinical grounds.
Ultimately, the precise classification of the observed epileptic phenomena in a given subgroup of patients with nonconvulsive status epilepticus does not change the probability that prophylactic doses of chloroquine were responsible for the seizure observed in our patient. Indeed, both partial complex status epilepticus and absence status have been described as secondary to nonfocal cerebral disease [4].
Paul Mulhauser, MD
Yves Allemann, MD
Claude Regamey, MD
Hopital Cantonal
1708 Fribourg, Switzerland
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
