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Spectrum and Predictors of Refractory Status Epilepticus in a Developing Country.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Dubey, Deepanshu Bhoi, Sanjeev Kumar Kalita, Jayantee Misra, Usha Kant |
| Copyright Year | 2017 |
| Abstract | OBJECTIVE Refractory status epilepticus (RSE) can influence the outcome of status epilepticus (SE). In the present study, we report the aetiology and predictors of outcomes of RSE in a developing country. METHODS This is a prospective hospital-based study of SE patients (continuous seizures for five minutes or more). Those who had SE persisting after two antiepileptic drugs were defined as having RSE. We present the demographic information, duration, and type of SE, and we note its severity using the status epilepticus severity score (STESS), its aetiology, comorbidities and imaging findings. The outcome of RSE was defined as cessation of seizures and the condition upon discharge, as assessed by the modified Rankin Scale. RESULTS A total of 35 (42.5%) of our 81 patients had RSE. The median duration of SE before starting treatment was 2 hours (range=0.008-160 h). The most common causes of RSE were stroke in 5 (14.3%), central nervous system (CNS) infections in 12 (34.3%) and metabolic encephalopathies in 13 (37.1%) patients. Some 21 (60%) patients had comorbidities, and the STESS was favourable in 7 (20%) patients. A total of 14 (20%) patients died, but death was directly related to SE in only one of these. Some 10 patients had super-refractory status epilepticus, which was due to CNS infection in 5 (50%) and metabolic encephalopathy in 3 (30%). On multivariate analysis, an unfavourable STESS (p=0.05) and duration of SE before treatment (p=0.01) predicted RSE. Metabolic aetiology (p=0.05), mechanical ventilation (p60 years (p=0.003) were predictors of poor outcomes. CONCLUSIONS RSE was common (42.5%) among patients with SE in a tertiary care center in India. It was associated with high mortality and poor outcomes. Age above 60 years and metabolic aetiology were found to be predictors of poor outcomes. |
| Starting Page | 538 |
| Ending Page | 546 |
| Page Count | 9 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://www.cambridge.org/core/services/aop-cambridge-core/content/view/07D4DCF2339248648C84B7B5791B7705/S0317167117000282a.pdf/spectrum_and_predictors_of_refractory_status_epilepticus_in_a_developing_country.pdf |
| PubMed reference number | 28446263v1 |
| Alternate Webpage(s) | https://doi.org/10.1017/cjn.2017.28 |
| DOI | 10.1017/cjn.2017.28 |
| Journal | The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques |
| Volume Number | 44 |
| Issue Number | 5 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Brain Diseases Brain Diseases, Metabolic CNS disorder Central Nervous System Infection Cerebrovascular accident Cessation of life Encephalopathies Mechanical ventilation Metabolic Process, Cellular Patients Respiration Seizures Status Epilepticus TYRO3 wt Allele Tertiary Care Centers Tertiary Healthcare |
| Content Type | Text |
| Resource Type | Article |
