Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice

• Published in: Neurologia (Barcelona, Spain) Vol. 32; no. 5; p. 284
• Main Authors: de la Morena Vicente, M A, Granizo Martínez, J J, Ojeda Ruiz de Luna, J, Peláez Hidalgo, A, Luque Alarcón, M, Navacerrada Barrero, F J, Al Hussayni Husseini, S, García Cobos, E, Ballesteros Plaza, L, de Las Casas Cámara, G, Viudez Jiménez, I
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01-06-2017
• Subjects: Anticonvulsants - therapeutic use; Epilepsy - drug therapy; Female; Humans; Male; Middle Aged; Retrospective Studies; Status Epilepticus - drug therapy; Status Epilepticus - mortality; Time Factors; Parcial complejo; Estatus epileptico; Partial motor; Prognosis; Pronóstico; Treatment; Parcial motor; Tonic-clonic; Complex partial; Tónico-clonico; Tratamiento; Status epilepticus
• ISSN: 1578-1968
• DOI: 10.1016/j.nrl.2015.11.018

Status epilepticus (SE) is a neurological emergency associated with significant mortality and morbidity. We analyse characteristics of this entity in our population.
Data from electronic medical records of adults diagnosed with SE were collected retrospectively from 5 hospitals over 4 years.
Data reflected 84 episodes of SE in 77 patients with a mean age of 60.3 years. Of this sample, 52.4% had a previous history of epilepsy. Status classification: 47.6% tonic-clonic, 21.4% complex partial, 17.9% partial motor, 6% partial simple, 3.6% myoclonic, and 3.6% subtle SE. Based on the duration of the episode, SE was defined in this study as early stage (up to 30min) in 13.1%, established (30-120min) in 20.2%, refractory (more than 120min) in 41.7%, and super-refractory (episodes continuing or recurring after more than 24h of anaesthesia) in 13.1%. Ten patients (11.9%) died when treatment failed to control SE. The cumulative percentage of success achieved was 8.3% with the first treatment, 27.3% for the second, 48.7% for the third, 58.2% for the fourth, 70.1% for the fifth, 80.8% for the sixth, 83.2% for the seventh, and 84.4% for the eighth.
In our study, we found that SE did not respond to treatment within 2h in approximately half the cases and 11.9% of the patients died without achieving seizure control, regardless of the type of status. Half the patients responded by the third treatment but some patients needed as many as 8 treatments to resolve seizures. Using large registers permitting analysis of the different types and stages of SE is warranted.