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Objective: We aimed to assess the usefulness of the Salzburg Consensus Criteria (SCC) for determining the prognosis of critically ill patients with nonconvulsive status epilepticus (NCSE)., Methods: We retrospectively reviewed consecutive patients with unconsciousness followed up in the intensive care unit (ICU). Three clinical neurophysiologists, one of them blinded to clinical and laboratory data, reevaluated all EEG data independently and determined NCSE according to SCC. The incidence of NCSE and ictal EEG patterns and their relationship to clinical, laboratory, neuroradiological, and prognostic findings were assessed., Results: A total of 107 consecutive patients with mean age 68.2 ± 15.3 years (57 females) were enrolled in the study. Primary neuronal injury was detected in 59 patients (55.7%). Thirty-three patients (30.8%) were diagnosed as NCSE. While authors decided to treat 33 patients (30.8%), 32 patients (29.9%) had been treated in real-life evaluation. Clinical and EEG improvement were detected in 12 patients (11.3%) in real-life treatment group showing correlation with lack of intubation and ICU stay related to postsurgical event. Rate of mortality (45.8%) was high showing association with systemic-metabolic etiology, severity of coma and presence of "plus" modifiers in the EEG., Conclusion and Significance: Our findings suggest that SCC is highly compatible with clinical practice in the decision for treatment of patients with NCSE. The presence of "plus" modifiers in the EEG was found to be associated with mortality in these patients and was a significant marker for the high mortality rate.

Introduction: Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in patients with chronic drug-resistant epilepsy, and peri-ictal prone position has been elucidated as a risk factor for SUDEP. We aimed to investigate consecutive patients in peri-ictal prone positions in our video EEG monitoring (VEM) unit and compare patients with and without peri-ictal prone position to emphasize its relationship with other independent risk factors for SUDEP., Methods: We retrospectively screened all patients with peri-ictal prone position who underwent VEM for a 10-year period and these patients constituted the prone (+) group. All patients without peri-ictal prone position who underwent VEM in the past 2 years constituted the prone (-) control group. Sequences of peri-ictal positions and interventions were evaluated. Clinical and laboratory features and SUDEP-7 scores were compared between the groups., Results: A total of 21 seizures were identified with peri-ictal prone position from 16 patients. SUDEP-7 scores were significantly higher in the prone (+) group. Longer duration of epilepsy, early age at seizure onset, mental retardation, and frequency of seizures of any type (>50 seizures per month for the past year) were found significantly different between the prone (+) and prone (-) groups., Conclusion: Peri-ictal prone position in the VEM unit may relate with other independent risk factors of SUDEP, especially with mental retardation. Nocturnal supervision becomes important to reduce SUDEP risk, especially in patients with mental retardation.