Case-Based Modules > Case 16 > Conclusion

Great job! The key detail to recognize in this case, even as his arm was convulsing away, was that the patient's mentation was preserved.

Pearl 1: Recognize whether mental status is preserved in a patient with focal motor status epilepticus, as this can guide the aggressiveness of treatment.

Epilepsia partialis continua (EPC) refers to focal motor status epilepticus with preserved awareness. We can try treating this with first-line (benzodiazepines) and second-line (ASMs) medications. However, we should be careful so as to not oversedate them and give them a reason to get intubated, when it can be otherwise avoided. Of course, they should be closely monitored in the acute phase in case their mental status does decline, which would warrant the usual aggressive management.