Predictors and outcome of status epilepticus in cerebral venous thrombosis.

Abstract

We report the clinico-radiological characteristics of SE in the patients with cerebral venous thrombosis (CVT), and compare the relative risk of SE in determining death and disability compared with those patients with and without self-limiting seizures. Consecutive patients with magnetic resonance venography (MRV) confirmed CVT, admitted during 2006-2017, were included. Their clinical details, risk factors, and magnetic resonance imaging and MRV findings were noted. Duration of SE, Status Epilepticus Severity Score (STESS), Glasgow Coma Scale score, and response to antiepileptic drugs were noted. 6-month outcomes were noted using the modified Rankin Scale. Of 153 CVT patients, 28 (18.3%) had SE, 62 (40.5%) self-limiting seizures, and 63 (41.2%) did not have seizures or SE. The SE group had a higher incidence of focal motor deficit (71.4% vs. 33%, P = 0.006) and supratentorial lesions (93% vs 55.5%, P = 0.003) than the no-seizure group. Multivariate analysis of SE and no-SE group (includes self-limiting and no seizure) did not indicate any significant predictor, but multivariate analysis of SE and no-seizure group indicated that supratentorial lesion only predicted SE (odds ratio 5.65, 95% confidence interval 1.11-28.76; P = 0.03). Patients with SE and self-limiting seizure had similar clinical and MRI findings. In total, 17.8% had refractory SE; refractoriness was related to the pretreatment duration of SE (P < 0.001). The death and disability were not significantly different between the three groups. At 6 months, 84% patients with SE, 92.3% with self-limiting seizure, and 94.8% in no-seizure group had good recovery.