Factors affecting prognosis of status epilepticus among patients presenting to a tertiary care hospital (original) (raw)
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Status Epilepticus: Etiology, Outcome and Predictors of Mortality
Iranian journal of child neurology, 2007
Objective study was designed to determine the etiology of status epilepticus (SE) and its relation to mortality. Materials and Methods This descriptive study was carried out based on the medical records of 40 patients with diagnosis of SE discharged from pediatric hospital of Bandar Abbas between March 2002 and March 2004. Multivariant analysis was pereformed to determine the prevalence of the disorder and the relation between SE and other factors such as gender, age, response to treatment, and mortality. We classified the etiology according to international league against epilepsy (ILAE) classification and also uses another classification regarding underlying causes such as fever (non-CNS infection), central nervous system infection, hypoxia, and metabolic causes. Results epilepticus was responsible for 0.3% of all hospital admissions during the study period. Based on the ILAE classification, frequencies for acute symptomatic, febrile, progressive encephalopathic, remote, and crypt...
Archives Of Epilepsy
INTRODUCTION Status epilepticus (SE) is defined as a seizure that lasts longer than expected, or the recurrence of many seizures without any improvement in the newly developed condition. The duration of sustained seizure activity used for the above definition varied over time. In 2015, the International League Against Epilepsy (ILAE) specified two different temporal concepts for the definition of SE-t1 (five min; time when ongoing seizure activity is abnormally prolonged, unlikely to stop spontaneously, and when treatment for SE should be initiated) and t2 (30 min; when continued seizure activity poses a significant risk of long-term complications). Accordingly, SE is the condition that results from the failure of the mechanisms responsible for seizure termination or the initiation of mechanisms that lead to abnormally prolonged seizures. Depending on the type and duration of seizures, neuronal damage occurs because of neuronal death and neuronal networks change. Semiologically, it is divided into two groups-convulsive and non-convulsive SE. A continuous seizure lasting 5 min or longer, or 2 or more consecutive seizures in which there is no complete recovery of consciousness between, is currently considered generalized convulsive SE. Refractory SE is a condition that does not respond to first-line and second-line medical treatments and exceeds 30-60 minutes. SE is a relatively common medical and neurological emergency that requires prompt evaluation and treatment. There are different SE syndromes, which differ in etiological factors, prognosis, and treatment, as defined by clinical features and electroencephalography (EEG) findings. Optimal evaluation and treatment can only be performed by understanding the type of SE presented and its underlying cause. Causes, risk factors, and prognosis of SE may vary among centres, regions, and countries. In this study, clinical and demographic features, the etiological causes, treatment and mortality of convulsive SE cases followed up and treated in our hospital in the last 7 years were evaluated.
Bangladesh Journal of Medical Science
Background: Status epilepticus is one of the common neurological emergencies associated healthcare costs, morbidity and mortality worldwide. The prevalence is more in extreme ages, in adults as well as in children. However, it can occur at any age. Aim: The aim of this study was to determine the possible causes and outcomes of status epilepticus in adults. Method: Across-sectional study was conducted in the department of Neurology, at Jinnah Postgraduate Medical College, Karachi during January 2015 to March 2016. All patients of either gender between 18-60 years of age diagnosed for status epilepticus, presented within 24 hours of their first episode of status epilepticus were included in the study. Patients were examined for the assessment of nature, type and presence or absence of precipitating factors (noncompliance, systemic infection, head trauma and central nervous system infections). Data was entered and analyzed by using SPSS version 19.0. Results: A total number of 241 pati...
Analysis of clinical characteristics and risk factors for mortality in human status epilepticus
Seizure, 2003
To analyse clinical data including aetiology, age, antecedents, classification and mortality in human status epilepticus (SE), and to assess prognostic factors for mortality. Methods: A prospective study was performed, including detailed analysis of clinical and laboratorial data of SE in individuals of any age, except neonates. Results: One hundred and eleven SE were included, with patients' age ranging from 3 months to 98 years. SE incidence peaked in the first year of life, and 59.4% of the individuals had previous epilepsy while 40.6% had not. The main underlying causes were noncompliance to treatment in the first group, and CNS infection, stroke and metabolic disturbances in the second group. Overall mortality was 19.8%, and deaths were correlated to aetiology and patient's age. Refractory SE affected 11.7% of the cases. Clinical types included focal, secondarily generalised and generalised SE. Clinical and clinicoelectrographic classifications were convergent, but EEG was essential for the diagnosis in 4.5% of the cases. Conclusions: Epileptic patients are at greater risk to develop SE, however, individuals with no prior history of epilepsy and acute neurological problems can also present SE. Aetiology varies with patient's age, and mortality is high and related to age and underlying causes. Clinical and clinicoelectrographic classifications are usually convergent, but in some cases the diagnosis of SE would not be established without the EEG.
Journal of Neurology, 2021
Background Status epilepticus (SE) can occur in persons with or without epilepsy and is associated with high morbidity and mortality. Methods This survey aimed to record self-reported frequency of SE in persons with epilepsy, its association with clinical characteristics and patient level of information on SE and rescue medication. 251 persons with epilepsy at a tertiary epilepsy center were included in the study. Results 87 (35%) had a history of SE defined as seizure duration of more than 5 min. These patients were less likely to be seizure-free, and had a higher number of present and past anti-seizure medication. Female sex, cognitive disability, younger age at epilepsy onset, defined epilepsy etiology, and focal epilepsy were associated with a history of SE. On Cox regression analysis, female sex, defined etiology and focal classification remained significant. 67% stated that they had information about prolonged seizures, and 75% knew about rescue medication. 85% found it desira...
Status Epilepticus in Our Patients, 15-Years Follow-Up Study
Scripta Medica, 2018
Introduction: Status epilepticus (SE) is the second most frequent neurological emergency. The purpose of this study was to analyse clinical presentation, causes and outcome of SE. Aim of the Study: The aim was to establish clinical characteristics, etiology and the outcome of status epilepticus as well as sex and age distribution in patients hospitalized at the Clinic of Neurology UCC RS in a 15-year follow-up. Patients and Methods: In this prospective 15-year study, all patients with SE admitted to the University Clinical Center of Republic of Srpska, Clinic of Neurology, were treated in the period of 15 years (2003-2017). Demographic and clinical data were collected. Results: In the aforesaid period, 124 patients with SE were treated, and there were 71 man (57%) with mean age of 59 years and 54 woman (43%), with mean age of 52.5 years. Primarily generalized tonic-clonic SE was identified in 70 (56%) and 44 (35.2%) patients, retrospectively. Simple partial SE occurred in 10 (8%) patients. 62% of the patients had previously had epilepsy while 38% had not. The main underlying causes were noncompliance to treatment in the first group (n=56; 72%) and cerebrovascular disease (n=36; 75%) in the second group. Overall mortality rate was 11.2% , which correlated with acute symptomatic etiology and patients of older age (mean: 73 years). Conclusion: Epileptic patients are at greater risk to develop SE. However, in patients with no prior history of epilepsy and acute neurological problems SE may also occur. Cerebrovascular disease was the most common cause of SE in those with the initial seizure. Noncompliance to treatment was the major cause in patients with preexisting epilepsy.
Status epilepticus in adults: A study from Nigeria
Predictor Outcome Status epilepticus Nigeria a b s t r a c t Background: Status epilepticus (SE) is a common neurologic emergency. Immediate treatment to stop seizure activity and prompt diagnostic evaluation to recognize potentially treatable causes are paramount in the management of SE. Thus, increased awareness of presentation, etiologies, and treatment of status epilepticus SE is central in the practice of critical care medicine. However, there is a paucity of information on SE from Nigeria. Objective: We evaluated the clinical profile and predictors of one-month outcome in a group of Nigerian patients with SE.
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.12\_Dec2021/IJRR-Abstract027.html, 2021
Introduction: Status epilepticus is a neurological condition caused by a failure of body mechanism to terminate the seizures or the onset of abnormal seizure activity resulting in prolonged seizure's duration for more than five minutes. The available research data on status epilepticus in Indonesia is still limited. The purpose of this study was to determine the profile of patients with status epilepticus at Sanglah General Hospital from 2020 to 2021. Methods: This was a descriptive study with a retrospective approach. The study populations were patients with status epilepticus who were treated at Sanglah General Hospital in 2019-2020 who had no missing data in the medical records. Results: There were 117 patients with status epilepticus, 63 males (53.8%) and 54 females (46.2%). There are 41 patients >60 years (35%), general onset in 63 patients (53.8%), and focal onset in 54 patients (46.2%). Etiology from cerebral was 68 patients (58.1%), followed by metabolic in 28 patients (23.9%). The most common OAE therapy was phenytoin (86.3%) and the longest length of stay status epilepticus patients was 8 days (55.6%). Patients with status epilepticus had leukocytosis (73.5%), increased NLR (66.7%), and decreased mean platelet volume (53.8%). Conclusion: The highest incidence of status epilepticus is in women, above 60 years, general onset type of seizure, and etiology from cerebral. Initial therapy in 117 patients was intravenous diazepam followed by phenytoin for maintenance. NLR increased in most of the patients showing signs of inflammation which further worsened the patient's outcome with a mortality rate of 47%.