Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

Liberalesso, Paulo Breno Noronha; Garzón, Eliana; Yacubian, Elza Márcia Targas; Sakamoto, Américo Ceiki

doi:10.1590/s0004-282x2012000700006

Cited by 5 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Twenty-one patients (m 13, f 8; 32%) with NCSE had refractory NCSE , i.e. seizures lasting more than 60 minutes with failure of two ASDs [ 37 ]; 10 patients received midazolam IV, 5 propofol IV, 4 thiopental IV, and 2 patients fentanyl IV; 12 patients (m 8, f 4; 57%) survived; only 7 patients (m 4, f 3; 33%) recovered completely; 9 patients with Refractory NCSE died (m5, f 4; 43%): they suffered from cardiac arrest (3), sepsis (3), ischemia (1), subarachnoid hemorrhage (1) and cerebral abscess (1)…”

Section: Resultsmentioning

confidence: 99%

Clinical presentation, epidemiology, neurophysiological findings, treatment and outcome of nonconvulsive status epilepticus: a 3-year prospective, hospital-based study

Mesraoua

Deleu

Hail

et al. 2017

Journal of Drug Assessment

View full text Add to dashboard Cite

Objective: This study reports the prevalence of Nonconvulsive Status Epilepticus (NCSE) in patients with altered mental status (AMS), and describes the clinical presentation, etiology, neurophysiological findings, neuroimaging, treatment, and outcome of NCSE in Qatar. Recording duration of continuous EEG monitoring was also discussed. Methods: This was a 3-year, prospective, hospital-based study involving patients with AMS and continuous EEG monitoring admitted to the Emergency and ICUs of Hamad Hospital, Qatar. Patients with confirmed diagnosis of NCSE were compared to the patients who did not show EEG and clinical features compatible with NCSE. Descriptive statistics in terms of mean with standard deviation, as well as frequency and percentages for categorical variables, were calculated; Student’s t test as well as Chi-square tests or Fisher’s exact tests were applied. Logistic regressions NSCE was performed using significance level 0.05 for independent variables at univariate analysis. Results: Number of patients with AMS and continuous EEG monitoring was 250. Number of patients with EEG compatible with NCSE: 65 (age range, 12–79 ys; m, 37; f, 28). Number of controls (defined as patients with EEG not compatible with NCSE): 185 (age range, 12–80 ys; m, 101; f, 84). Rate of occurrence of NCSE in patients with AMS: 26%. NCSE group was younger than controls (p < .001). Twenty patients with NCSE (31%) and 35 patients in the control group (19%) died. Death was more frequent in comatose NCSE compared to controls (p < .0007). NCSE proper and comatose NCSE had longer hospital stays than controls (p < .02 and p < .03, respectively). Complete recovery occurred in 26 NCSE patients (40%) and in 98 controls (53%) (p < .08). Twenty-one patients (31%) presented with refractory NCSE: 12 patients survived, 9 died. Conclusion: This was the first prospective study reporting a high number of NCSE in Qatar, a small country in the MENA region. This prevalence (26%) was in the middle range. NCSE patients did not perform better than controls, outcome being worse with comatose NCSE. NCSE is an emergent condition warranting expedited diagnosis and management. Three days of continuous EEG monitoring were able to diagnose most cases of NCSE.

show abstract

Section: Resultsmentioning

confidence: 99%

Clinical presentation, epidemiology, neurophysiological findings, treatment and outcome of nonconvulsive status epilepticus: a 3-year prospective, hospital-based study

Mesraoua

Deleu

Hail

et al. 2017

Journal of Drug Assessment

View full text Add to dashboard Cite

show abstract

“…Thirty-two percent of patients with NCSE (n = 21, m 13, f 8) suffered from refractory NCSE, defined as seizures lasting more than 60 minutes with failure of two ASDs [37]; they received the following treatment: midazolam IV (n = 10), propofol (n = 5), thiopental (n = 4), and fentanyl (n = 2). Fifty-seven percent (n = 12, m 8, f 4) survived; forty-three percent (n = 9, m 5, f 4) died with the following reasons: cardiac arrest (3), sepsis (3), ischemia (1), subarachnoid hemorrhage (1), and cerebral abscess (1).…”

Section: Refractory Ncsementioning

confidence: 99%

Nonconvulsive Status Epilepticus in Patients with Altered Mental Status Admitted to Hamad General Hospital, Doha, Qatar

Mesraoua¹,

Deleu²,

Hail³

et al. 2019

Epilepsy - Advances in Diagnosis and Therapy

View full text Add to dashboard Cite

This is a prospective, hospital-based study reporting an update and the prevalence of nonconvulsive status epilepticus (NCSE) in patients with altered mental status (AMS) in Qatar. Patients presenting with NCSE are compared to controls. Two-hundred and fifty patients with AMS are involved. Patients with NCSE are: 65 (12-79 years, m, 37, f, 28); controls: 185 (12-80 years, m, 101, f, 84). Occurrence of NCSE in patients with AMS was 26%. NCSE patients were younger than controls (p < 0.001). Deaths in the NCSE group occurred in 31% and 19% in controls (p < 0.0007). Hospitalization length was longer in NCSE proper and in comatose NCSE compared to controls (p < 0.02, p < 0.03). Recovery occurred in 40% of NCSE patients and 53% of controls (p < 0.08). About 31% of patients (n = 21) had refractory NCSE and 9 died. This is the first study reporting the prevalence of NCSE in Qatar. This prevalence (26%) is in the middle range. NCSE did not do better than the controls, result being disappointing regarding comatose NCSE. NCSE is an emerging condition requiring rapid diagnosis and rapid treatment. Regarding the optimal duration of continuous EGG (cEEG) monitoring to diagnose the majority of NCSE cases, 3 days of cEEG monitoring could accomplish this task.

show abstract

“…The occurrence of SE/RSE is usually accompanied by other serious brain diseases, such as central nervous system infection, hypoxic encephalopathy after CPR, CJD, and other serious metabolic/toxic encephalopathy. These patients have complicated conditions, and it is particularly difficult to treat patients with PEDs, with poor prognosis [ 8 ]. On the basis of actively controlling the primary disease, how to quickly and effectively control the seizure and abnormal discharge and avoid adverse reactions has always been the focus of research and attention of experts and scholars at home and abroad.…”

Section: Introductionmentioning

confidence: 99%

Clinical Evaluation of Levetiracetam in the Treatment of Epilepsy

Liu

Fang

et al. 2022

Journal of Healthcare Engineering

View full text Add to dashboard Cite

Objectives. Epilepsy is a chronic neurological disorder that is characterized by episodes of seizure. Methods. In this study, patients with status epilepticus in the Intensive Care Unit of the Department of Neurology of Qujing First People’s Hospital were collected and treated with levetiracetam injection, continuous bedside EEG monitoring (cEEG) technology, and quantitative EEG (qEEG) technique. The inhibitory effects of different doses of levetiracetam injection and sodium valproate on abnormal discharge, the improvement of clinical symptoms, the incidence of adverse reactions, and prognosis were monitored, analyzed, and compared. Results. Compared with the experimental group of sodium valproate, 1000 mg/d levetiracetam group and 1500 mg/d levetiracetam group had a high probability of successful symptom control and a short control time. The patients had a low recurrence rate and a long recurrence time, and the probability of abnormal discharge in EEG was low. Conclusions. The recording results showed that levetiracetam could significantly inhibit the abnormal discharge of patients. Compared with sodium valproate, high-dose levetiracetam is a drug with a rapid effect, good effect, and long action time.

show abstract

Refractory nonconvulsive status epilepticus in coma: analysis of the evolution of ictal patterns

Cited by 5 publications

References 21 publications

Clinical presentation, epidemiology, neurophysiological findings, treatment and outcome of nonconvulsive status epilepticus: a 3-year prospective, hospital-based study

Clinical presentation, epidemiology, neurophysiological findings, treatment and outcome of nonconvulsive status epilepticus: a 3-year prospective, hospital-based study

Nonconvulsive Status Epilepticus in Patients with Altered Mental Status Admitted to Hamad General Hospital, Doha, Qatar

Clinical Evaluation of Levetiracetam in the Treatment of Epilepsy

Contact Info

Product

Resources

About