A clinical, radiological and outcome study of status epilepticus from India

Abstract

The objective of this study is to evaluate the clinical and radiological characteristics and the outcome of status epilepticus (SE). 117 consecutive patients with SE were evaluated including their demographics, history of epilepsy, antiepileptic drug (AED) default, comorbidities, SE type and duration. The study included 22 children, 77 adults and 18 elderly patients with SE. Blood counts, serum chemistry, ECG, cranial MRI, cerebrospinal fluid and EEG were done. Patients were treated with IV phenytoin, valproate, lorazepam or diazepam as per a fixed protocol and responses to first and second drugs were noted. Death during hospital was recorded. The etiology of SE was infection in 53.8%, drug default in 7.9%, metabolic in 14.5%, stroke in 12.8% and miscellaneous in 11% of patients. 92.3% of patients had convulsive and 7.7% nonconvulsive SE. Cranial MRI was abnormal in 62%. Infection as an etiology was more common in children, drug default and metabolic causes in adults and stroke in adults and elderly. Following first AED, SE was controlled in 50%. 30% of patients remained refractory to second AED which was related to duration of SE and mortality. 29% patients died and death was higher in elderly (44%) compared to children (14%). Acute symptomatic SE is more common in developing countries. Refractory SE is associated with SE duration and mortality.

Clinical Profile, Aetiology, and Short Term Outcome of Convulsive Status Epilepticus in Children in Eastern India

“…(16) . In this study most common abnormality detected was in neuro imaging cerebral oedema 27.2% which matches with the finding in two other Indian study like J Kalita (8) and S. Gulati study where average incidence of cerebral oedema was around 30%. (5) .…”

“…In this study most common type of seizure presented with status epilepticus was generalised tonic-clonic type 75%, followed by partial 25%. This picture tally with different Indian studies (5,7,8) and also western studies (9,10) . But DeLorenzo RJ et al study from Virginia in 1996 reported incidences of partial seizure presented with status epilepticus was much higher 64%.This inconsistency may be due to different study population as that study was mainly adolescence based.…”

“…This picture was quite similar with the mortality rate of SE in J Kalita et al study in 2010 where the percentage was 14%. (8) Though Gulati et al .in their study found 30 % mortality .That study was done almost 15 years back. Improvement in management decreased mortality.…”

A Study on Clinico-Radiological Profile of Children Presenting with Seizure in a Tertiary Care Hospital in Nepal: A Cross-Sectional Study

“…In this study, the percentage of GTCS was higher in all the age groups. Infection as an etiology is more common in children, whereas drug default and toxic-metabolic causes are common in adults, who present to with seizures (4)(5)(6) . Generalized tonic clonic seizure was the most common type of seizure noticed at initiation of this study, as has been the experience in other studies as well (4)(5)(6) .…”

A study of the etiology and short term outcome of status epilepticus in children

“…8 The recognition and rapid treatment of seizures is important during acute illness. [9][10][11] The failure to diagnose status epilepticus leads to high mortality. Lately it is becoming increasingly recognized that seizure duration of more than 10 minutes can lead to brain damage and duration of seizure activity in definition of status epilepticus is being decreased.…”