Background Non-convulsive status epilepticus (NCSE) is a reversible cause of impaired consciousness and acute CNS infections represent an important, potentially treatable precipitant. Current prevalence and man- agement are poorly understood.

Method In a point-prevalence study, all consecutive admissions to an acute-medical-unit (AMU) in Zambia were screened and those with an abnormal Glasgow Coma Score (GCS) assessed for clinical signs of NCSE over a two-week period. Demographic, retroviral, and clinical data were collected.

Results 304 patients were identified. 49 (16%) had an abnormal GCS, median [range] 8 [3–14]. The majority, 30 (61.2%) were due to CNS or other infection. A large proportion, 16 (32.7%), had clinical signs requiring investigation for possible NCSE. Only a third was started on antiepileptic drugs and none had electroencephalography (EEG).

Conclusion This study found that altered GCS was common in patients admitted in an AMU in sub-Saharan Africa, that this was commonly due to CNS or systemic infection, and many patients had clinical features suspicious for NCSE. However, the majority did not have treatment and none had EEG. Future studies are planned to determine the exact incidence of NCSE confirmed by EEG to develop and implement programmes to improve clinical management of NCSE in this setting.