Nonconvulsive seizures (NCS) are seizures that have subtle or no clinical motor phenomena in a patient with impaired consciousness.  Nonconvulsive status epilepticus (NCSE), is a subtype of status epilepticus. NCSE denotes an enduring epileptic condition with reduced or altered consciousness ranging from confusion to coma, behavioral and vegetative abnormalities, or merely subjective symptoms like auras, but without major convulsive movements (1)   NCS occur in 10–25 % of patients with acute brain injury and are associated with worse outcomes  (2). NCSE is also seen a third of patients  presenting with altered mental status to the emergency department ( 3.) Indeed, a diagnosis of NCSE is often missed  both in  the emergency room and in the ICU,  because of its  pleomorphic presentation, often in the  setting of other serious illnesses.