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Two emergency-room cases were presented: a 61-year-old man and an 80-year-old woman with severe aphasia. Both were treated for status epilepticus with subsequent symptom resolution. EEG and SPECT findings supported ASE, and delayed recognition was emphasized. ASE should be considered a stroke mimic and treated promptly with benzodiazepines once ischemic stroke is excluded by MRI.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/aphasic-status-epilepticus-treated-in-the-emergency-room-a-report-of-two-cases/445024/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/aphasic-status-epilepticus-treated-in-the-emergency-room-a-report-of-two-cases/445024.png","ImageObject",300,407,{"name":92,"@type":93},"jayni","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is aphasic status epilepticus (ASE) and why is it difficult to identify?","Question",{"text":112,"@type":113},"ASE is non-convulsive status epilepticus associated with aphasia, and its clinical characteristics and prognosis have been unclear. An EEG is required for diagnosis, but delays may occur when EEG is not available full-time.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the two cases in the emergency room managed?",{"text":117,"@type":113},"Both patients were treated immediately for status epilepticus in the emergency department. Their symptoms resolved during the acute phase, and in the second case the patient later had recurrence treated again with immediate symptom resolution.",{"name":119,"@type":110,"acceptedAnswer":120},"What diagnostic clues and treatment guidance does the article provide?",{"text":121,"@type":113},"EEG supported ASE in both cases, and SPECT helped demonstrate high-uptake lesions. The article recommends considering ASE as a stroke mimic and treating suspected ASE immediately with benzodiazepines without waiting for EEG or perfusion imaging when MRI rules out ischemic stroke.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},445024,1790742652,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},3985747859343,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Review began 11/15/2025  \nReview ended 12/02/2025  \nPublished 12/07/2025  \n© Copyright 2025  \nInatomi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98642  \nOpen Access Case Report  \nAphasic Status Epilepticus Treated in the Emergency Room: A Report of Two Cases  \nYuichiro Inatomi 1, Makoto Nakajima 2, Toshiro Yonehara 3  \n1. Neruology, Saiseikai Kumamoto Hosiptal, Kumamoto, JPN 2. Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JPN 3. Neurology, Saiseikai Kumamoto Hospital, Kumamoto, JPN  \nCorresponding author: Yuichiro Inatomi, [y.inatomix@silk.ocn.ne.jp](y.inatomix@silk.ocn.ne.jp)  \nAbstract  \nThe clinical characteristics of patients with an aphasic status epilepticus (ASE) remain unclear. Here, we present two cases with ASE. Case 1 was a 61-year-old man who was admitted to our hospital with cortical deafness and severe aphasia. He was treated in our emergency department for status epilepticus, and his symptoms resolved. Electroencephalography (EEG) showed lateralized periodic discharges in the left temporo-parietal lobes. Single-photon emission computed tomography (SPECT) showed a high-uptake lesion in the left temporo-parietal lobes. Case 2 was an 80-year-old woman who was admitted to our hospital with tonic-clonic seizures. Even after she became alert, she continued to have severe aphasia. EEG showed generalized spike-and-slow wave complexes. She was treated for status epilepticus, and her symptoms resolved. SPECT after her aphasia resolved showed high-uptake lesions in both parietal lobes. Atthe time of her recurrence 2.5 years later, she was treated in our emergency department for status epilepticus, and her symptoms immediately resolved. Both cases were diagnosed with aphasic status epilepticus. ASE should be considered as a stroke mimic and may cause sequelae due to delayed treatment. We recommend that patients suspected of ASE should be treated immediately with benzodiazepine without waiting for electroencephalography or perfusion imaging when ischemic stroke is ruled out by MRI, including diffusion-weighted imaging (DWI) .  \nCategories: Therapeutics, Neurology, Emergency Medicine  \nKeywords: aphasia, aphasic status epilepticus, epilepsy, non-convulsive status epilepticus, stroke mimics  \nIntroduction  \nNon-convulsive status epilepticus (NCSE) represents a prolonged status of seizure (status epilepticus (SE)) without marked motor manifestations [1] . NCSE with aphasia is called aphasic status epilepticus (ASE) and has been referred to separately since its first description by de Pasquet et al. (1976) [2] . Rosenbaum et al.(1986) and Grimes et al. (1997) defined ASE as follows: 1) the patient must have language production (“speaking” in Rosenbaum’s article) during seizures; 2) language production must show aphasic features (Rosenbaum suggested dysfluency, dysnomia, or paraphasia as examples of aphasia) ; 3) consciousness must be preserved ; 4) the seizures must be correlated with the aphasia, as documented by electroencephalography (EEG) and behavioral testing; and 5) (added by Grimes) the aphasia should resolve, or nearly so, concurrent with the successful treatment of the seizures [3, 4]. Since the publication of these reports, ASE has been diagnosed based on this definition and has been described in many case reports and case series reports [5-8].  \nAs stated in the definition above, an EEG is required to diagnose ASE, although it is believed that many medical facilities are unable to perform an EEG on a full-time basis. Thus, there is a concern about delays in diagnosis and treatment for patients with ASE. However, the clinical characteristics and prognosis of patients with ASE are still unclear.  \nIn this article, we present two cases with ASE. Both pat","cbCaijWo8IqHm4QP","https://ap.wps.com/l/cbCaijWo8IqHm4QP","pdf",3891008,"English","# Abstract\n# Introduction\n# Case Presentation\n## Case 1\n## Case 2\n# Conclusion","[{\"question\":\"What is aphasic status epilepticus (ASE) and why is it difficult to identify?\",\"answer\":\"ASE is non-convulsive status epilepticus associated with aphasia, and its clinical characteristics and prognosis have been unclear. An EEG is required for diagnosis, but delays may occur when EEG is not available full-time.\"},{\"question\":\"How were the two cases in the emergency room managed?\",\"answer\":\"Both patients were treated immediately for status epilepticus in the emergency department. Their symptoms resolved during the acute phase, and in the second case the patient later had recurrence treated again with immediate symptom resolution.\"},{\"question\":\"What diagnostic clues and treatment guidance does the article provide?\",\"answer\":\"EEG supported ASE in both cases, and SPECT helped demonstrate high-uptake lesions. The article recommends considering ASE as a stroke mimic and treating suspected ASE immediately with benzodiazepines without waiting for EEG or perfusion imaging when MRI rules out ischemic stroke.\"}]","Aphasic Status Epilepticus Treated in the Emergency Room - A Report of Two Cases | PDF",1790710086,18]