RESUMO
OBJECTIVE: This study investigated whether there is an association between semiology of status epilepticus (SE) and response to treatment and outcome. METHOD: Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2±17.5 (18-97) years. Patient demographics, SE semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). RESULTS: The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS≤3) with an overall mortality of 12.4%. SE was refractory to treatment in 21.5% of the patients. Older age, potentially fatal etiology, systemic infections, NCSE in coma, refractory SE, treatment with anesthetics, long SE duration (>24h), low Glasgow Coma Scale (GCS) (≤8) at onset, and high Status Epilepticus Severity Score (STESS-3) (≥3) were associated with poor short-term outcome and death (p<0.05). Potentially fatal etiology and low GCS were the strongest predictors of poor outcome (Exp [b]: 4.74 and 4.10 respectively, p<0.05). CONCLUSION: Status epilepticus semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.
Assuntos
Anticonvulsivantes/uso terapêutico , Estado Epiléptico/epidemiologia , Estado Epiléptico/terapia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/fisiopatologia , Transtornos Cerebrovasculares/terapia , Coma/epidemiologia , Coma/fisiopatologia , Coma/terapia , Eletroencefalografia/tendências , Feminino , Escala de Resultado de Glasgow/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estado Epiléptico/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
We compared the rate of epilepsy and status epilepticus (SE) in patients with and without Parkinson's disease (PD). Out of 1215 patients with idiopathic PD, 31 had epilepsy and 19 of these had at least one episode of SE (61.3%) compared to 298 of 2537 patients (11.7%; p<0.001) with epilepsy and without concomitant PD. This clinical finding supports the hypothesis that the functional impairment of the basal ganglia in PD patients makes SE more likely.