BACKGROUND Nonconvulsive status epilepticus (NCSE) is a state of ongoing seizure activity without convulsions. The heterogeneous and subtle clinical features of NCSE make diagnosis and treatment challenging. Here, we report a patient with NCSE who showed a main presenting symptom of acute visual impairment, which is a rare and atypical clinical symptom of NCSE. CASE PRESENTATION A 62-year-old man was admitted to the neurology department after complaining of an inability to see in the right eye for 2 days and progressive headache. He had a history of poststroke epilepsy and vascular dementia. Physical examination revealed right visual field hemianopia, visual neglect and cognitive impairment. T2 and diffusion-weighted magnetic resonance imaging showed high signal intensity in the left temporal, parietal and occipital lobes. Electroencephalography monitoring was performed, which found continuous sharp wave discharges, especially in the regions of the left temporal, parietal and occipital lobes. These findings were most consistent with the diagnosis of NCSE. Thus, a treatment of intravenous pumping of diazepam and an oral antiepileptic drug was added immediately. After that, the visual loss in the patient recovered quickly, and electroencephalography did not find epileptiform waves. On day 11, a follow-up MRI was performed, which showed that the abnormal signals of the left temporal, parietal and occipital lobes were markedly attenuated, and the patient returned to his premorbid state with a modified Rankin Scale score of 3. CONCLUSIONS Acute visual impairment can be seen in NCSE, and it can be reversed by administering effective antiepileptic treatment. Meanwhile, transient peri-ictal MRI abnormalities can be observed in NCSE.

中文翻译：

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急性视力障碍是非惊厥性癫痫持续状态的主要症状：一例。

背景技术非惊厥性癫痫持续状态（NCSE）是持续发作而不发作的状态。NCSE的异质性和微妙的临床特征使诊断和治疗面临挑战。在这里，我们报道了一位患有NCSE的患者，其主要表现为急性视力障碍症状，这是NCSE的一种罕见且非典型的临床症状。病例介绍一名62岁的男子因抱怨右眼看不见2天和进行性头痛而入院神经内科。他有中风后癫痫和血管性痴呆病史。体检发现右视野偏盲，视力疏忽和认知障碍。T2和弥散加权磁共振成像显示左侧颞叶，顶叶和枕叶具有高信号强度。进行了脑电图监测，发现连续的尖波放电，特别是在左侧颞叶，顶叶和枕叶的区域。这些发现与NCSE的诊断最一致。因此，立即添加了地西epa静脉泵送和口服抗癫痫药的治疗方法。此后，患者的视力丧失迅速恢复，脑电图未发现癫痫样波。在第11天，进行了MRI随访，发现左侧颞叶，顶叶和枕叶的异常信号明显减弱，患者恢复了病前状态，改良的兰金评分为3分。结论急性在NCSE中可以看到视力障碍，可以通过进行有效的抗癫痫治疗来逆转视力障碍。与此同时，