The clinical analysis of new‐onset status epilepticus

Abstract

Objective: To investigate and analyze the etiology and prognosis of patients with new-onset status epilepticus (NOSE). Methods:We conducted a retrospective analysis of all adult patients (≧16 years old) who were admitted to Sichuan Provincial People's Hospital between January 2018 and December 2020 with status epilepticus (SE) and no prior epilepsy history. Results:We collected data from 85 patients, aged from 16 to 90 years, of whom 49 were male and 36 were female. Fifty-five of these cases (64.7%) were younger than 60 years of age. Acute symptomatic SE was mostly seen in the NOSE (53.9%), followed by unknown SE (25.9%), progressive SE (11.8%), and remote SE (9.4%). The differences in the etiology of NOSE between age groups were statistically significant (P < .05). For the young, the main etiology remained unknown (36.3%), followed by autoimmune-related SE (16.4%); in the elderly, the primary etiology was central nervous system (CNS) infection (23.3%), followed by cerebrovascular disease (20%), and intracranial tumors (20%). Normal imaging was mostly seen in young people with NOSE (P < .001).

Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcome

“…This fragility was not limited to the NOSE group: two-thirds of the patients had a significant disability (mRS ≥ 2) in both groups. The mean age of the patients in our study was 60 years, similar to the ages in previous cohorts: 60–65 years according to the cohort ( 15 , 17 , 23 , 24 , 45 – 47 ). However, NOSE generally occurs in older subjects (65 years vs. 56 years in NISE patients).…”

“…In a recent retrospective cohort including 85 NOSE patients, the main etiologies were acute symptomatic NOSE in 53.9%, unknown in 25.9%, progressive in 11.8%, and remote in 9.4%. For adults below the age of 60 years, the main etiology remained unknown (36.3%) followed by autoimmune-related SE (16.4%), while in the elderly (≥60 years), the primary etiology was central nervous system infection (23.3%) followed by cerebrovascular disease (20%) and intracranial tumors (20%) ( 23 ). In the 89 patients reported by Santamarina et al (mean age of 69 years), NOSE had an acute etiology for 66.3% of the patients (46.1% brain lesions and 20.2% toxic/metabolic causes), a remote or progressive etiology for 19.1% of the patients, and remained cryptogenic for 14.6% of the patients ( 27 ).…”

“…The incidence of NOSE was found to be 16.3/100,000 to 36/100,000 adults per year depending on the cohort and whether or not the new ILAE 2015 definition and classification of SE was taken into account ( 21 , 22 ). However, despite the incidence, knowledge of the clinical, EEG, and MRI spectrum of NOSE in adults is mostly based on retrospective data ( 11 , 20 , 23 – 25 ).…”

“…Mortality in 1 month is 20–61% depending on the cohort. Factors of poor prognosis are the age of the patient [especially over 65 years ( 11 )], etiology, and the duration of the SE ( 15 – 17 , 23 , 24 , 29 , 30 ). Tracheal intubation and co-infections are additional factors of adverse outcomes ( 23 ).…”

Distinctive magnetic resonance imaging features in primary central nervous system lymphoma: A case report

“…While previous studies have provided valuable insights into the broader understanding of PCNSL, there is a critical gap in characterizing the imaging features on an individual case level[ 3 ]. This study endeavors to bridge this gap by conducting an in-depth examination of DWI, PWI, and MR spectroscopy findings in a single PCNSL case.…”