Abstract
Objective: This study was to investigate the outcome of status epilepticus (SE) associated with antiepileptic therapy during SE and in follow-up period, risk factors including age, co-morbidities, pre-existing epilepsy, and etiology in the East-Hungarian region.Methods: A prospective cross-sectional database was compiled from outpatient files between 2013 and 2017. Follow-up ended on 30.06.2018.Results: One hundred and thirty five episodes (male: 68, 50.4%) were evaluated, mean age and follow-up time being 64.1 ± 13.9 years and 39.9 ± 14.2 months, respectively. Of the 89 patients with pre-existing epilepsy, 34 failed to visit the outpatient unit regularly. Case fatality rate was 25.2% and 31 patients (30.7%) died after discharge due to co-morbidities; their mean survival time was 10.44 ± 8 months. Focal, generalized and combined type epilepsies were diagnosed in 67 patients (49.6%), 47 patients (34.8%), and 21 patients (15.6%) of SE, respectively. Nine patients had non-convulsive SE (NCSE). Mean seizure-free period was 6.8 ± 6.9 months. Patients taking carbamazepine (20.9%; OR: 0.37, 95%CI: 0.16–0.82; p = 0.018), levetiracetam (27.5%; OR: 0.51, 95%CI: 0.27–0.97; p = 0.041), or valproate (11.1%; OR: 0.18, 95%CI: 0.05–0.61; p = 0.0043) were expected to achieve seizure freedom after SE. The worst outcome was linked to advanced age, etiology, new onset status epilepticus, NCSE, and focal status epilepsy.Conclusion: This study highlights the importance of regular care and patient follow-up.
Highlights
Status epilepticus (SE) is a condition and most extreme form of epilepsy [1], which leads to abnormal and prolonged seizure
Focal, generalized and combined type epilepsies were diagnosed in 67 patients (49.6%), 47 patients (34.8%), and 21 patients (15.6%) of SE, respectively
The worst outcome was linked to advanced age, etiology, new onset status epilepticus, non-convulsive SE (NCSE), and focal status epilepsy
Summary
Status epilepticus (SE) is a condition and most extreme form of epilepsy [1], which leads to abnormal and prolonged seizure (at least 5 min). In case SE persists over 30 min, it may have severe long-term consequences [2]. Referring to the new classification scheme of SE, there are two operational dimensions of the definition: time point 1 (T1) is associated with abnormally prolonged seizure, when therapy should be initiated, while time point 2 (T2) is related to the time of on-going seizure activity involving a risk of long-term consequences [2]. SE is one of the most common neurological emergencies [1]. It is a potentially life-threatening situation which needs a prompt and particular treatment [3] in order to prevent cerebral damage due to initial excitotoxicity [4]. Treatment is urgent because GABA sensitivity decreases and the sensitivity to excitotoxic neurotransmitters increases rapidly, leaving only a short time interval for
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