P02-T Clinical outcome and EEG patterns in superrefractory-nonconvulsive status epilepticus- single centre experience

Abstract

Background Nonconvulsive status epilepticus (NCSE) is a life threatening condition with very high mortality rate. The diagnosis is mainly based on electroencephalograpy (EEG). The aim was to study the EEG findings and epidemiology of superrefractory NCSE (SR-NCSE) in our center. Material and methods A retrospective database was compiled from patient files between 2013 and 2018. From 150 status epilepticus patients 13 were found to have SR-NCSE. EEG was evaluated ac-cording to the Salzburg Consensus Criteria. The following parameters were collected: status epilepticus severity score (STESS) and epidemiology-based mortality score in status epilepticus (EMSE), time until the diagnosis and clinical outcome. Results From the SE patients 8.6% had SR- NCSE, 77% of them female. The average age was 71.4 ± 21 years ( 90 30%.) The average time until the first EEG was 15.49 h, at the time of the diagnosis already in superrefractory stage. The mortality rate was very high (77%). The survivors had good outcome, modified Rankin scale 0–1. STESS and EMSE scores gave a good prediction of out-come. The 4 patients with burst-suppression pattern on EEG all died. The others had continuous epi-leptiform discharges (EDs, spikes and sharp waves). All who survived were alert or somnolent, and had an acute treatable aetiology. Only one patient had epileptic seizures previously and recovered. Conclusion Most NCSE cases stay hidden, or are diagnosed already in a refractory stage. Using STESS and EMSE scores helps to predict the outcome. Surveillance and education may improve the outcome and diagnosis of NCSE.