Status epilepticus in the elderly on a neurological intensive care unit

Abstract

WCN 2013 No: 2147 Topic: 1 — Epilepsy Status epilepticus in the elderly on a neurological intensive care unit A. Rohracher, D.P. Huber, J. Dobesberger, J. Hofler, H. Novak, A. Thomschewski, A. Zerbs, A. Akhundova, E. Trinka. Department of Neurology, Paracelsus Medical University, Salzburg, Austria; Department of Neurology, Medical University Azerbaijan, Baku, Azerbaijan Background: Status epilepticus (SE) is a common neurological emergency in the elderly and is associated with high morbidity and mortality. Objective: We aimed to compare clinical factors and outcome of SE in patients ≥60 and b60 years. Patients and methods: We analyzed 137 patients with SE admitted to our NICU between 1/2011 and 12/2012 retrospectively, grouped them according to age (≥60 and b60) and compared clinical factors, etiology and outcome between the groups. Results: Median age was 68 years (range 14–90), 62% were ≥60 yrs (85/137), and 38% (52/137) were b60 yrs. Tonic–clonic SE was the most frequent type in both groups (48% ≥ 60 vs. 58% b 60), comatose NCSE occurred more frequently in older patients (25% ≥ 60 vs. 6% b 60) (p = 0.466). SE lasted b30 min in 36% (49/137), 30–60 min in 26% (35/137) and N7 d in 4% (5/137) and did not differ between the groups (p = 0.97). 52% (71/137) had preexisting seizures (41% ≥ 60 vs.69% b 60) (p = 0.15). An acute symptomatic cause of SE was identified in 26% (36/137) with cerebrovascular diseases being more frequent in the elderly group (43% ≥ 60 vs. 10% b 60) (p b 0.01). Mortality was significantly higher in patients ≥60 (22% ≥ 60 vs. 6% b 60) (p = 0.01), moderate disability in younger patients (17% ≥ 60 vs. 42% b 60) (p b 0.01). Conclusion: In the elderly population SE occurs more often in patients without preexisting epilepsy and is most frequently caused by cerebrovascular diseases. Non-convulsive SE with coma occurs more frequently in patients ≥60. SE in older patients is associated with poorer outcome and higher mortality. doi:10.1016/j.jns.2013.07.169 Abstract — WCN 2013 No: 2488 Topic: 1 — Epilepsy Evaluation of cognitive deficit in patients with epilepsy measured with MMSE (mini mental state examination) WCN 2013 No: 2488 Topic: 1 — Epilepsy Evaluation of cognitive deficit in patients with epilepsy measured with MMSE (mini mental state examination) E. Suljic, A. Ilda, N. Subasic, I. Kapetanovic, A. Mehicevic. Neurology Clinic, University Clinical Center of Sarajevo, Bosnia and Herzegovina; Ophthalmology Clinic, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina Background: Cognitive deficit represents damage of intellectual abilities that manifest themselves in the form of disorientation in time and space, impaired attention and memory, inability to recognize, judgment and reasoning, and impairment of complex intellectual abilities such as analyzing and using information. Objective: To determine the prevalence and major parameters of cognitive deficits in patients with epilepsy, depending on the type of anti epileptic therapy compared to the control group. Patients and methods: Study enrolled 100 subjects of both sexes, the age structure of 18–65 years old who were divided into two groups: group with 60 patients suffering from epilepsy and a control group of 40 healthy subjects. Results: Of the total number of patients with epilepsy, 55% had cognitive deficits, where the deficit of attention and concentration was present in about 57% treated with valproate, 53% treated with carbamazepine and 42% treated with phenobarbital. Phenobarbital affected the understanding of spoken words by 16.6%, and the difficulties in tracing the figures were most pronounced in patients taking carbamazepine (76.47%) and lamotrigine (47%). Conclusion: The results showed significant incidence of cognitive deficits in patients with epilepsy compared to the control group. Patients with epilepsy had the most damaged domains of attention and concentration on the MMSE. Phenobarbital, carbamazepine and valproate are anticonvulsants that have led to the dominance of attention and concentration, while patients on carbamazepine and lamotrigine had major difficulties in tracing figures. doi:10.1016/j.jns.2013.07.170 Abstract — WCN 2013 No: 2505 Topic: 1 — Epilepsy The situation of the EEG service in a developing country/Egypt WCN 2013 No: 2505 Topic: 1 — Epilepsy The situation of the EEG service in a developing country/Egypt K.A.M.T. Ahmed. Neurology Department, Ain Shams University,