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De-novo non-convulsive status epilepticus in adult medical inpatients without known epilepsy: Analysis of mortality related factors and literature review.
García-Villafranca, Alba; Barrera-López, Lucía; Pose-Bar, Marta; Pardellas-Santiago, Elva; Montoya-Valdés, Jonathan G; Paez-Guillán, Emilio; Novo-Veleiro, Ignacio; Pose-Reino, Antonio.
Afiliación
  • García-Villafranca A; Internal Medicine Department, POVISA Hospital, Vigo, Pontevedra, Spain.
  • Barrera-López L; Internal Medicine Department, University Hospital of Santiago de Compostela, A Coruña, Spain.
  • Pose-Bar M; Internal Medicine Department, University Hospital of Ourense, Ourense, Spain.
  • Pardellas-Santiago E; Neurophysiology Department, University Hospital of Santiago de Compostela, A Coruña, Spain.
  • Montoya-Valdés JG; Internal Medicine Department, University Hospital of Santiago de Compostela, A Coruña, Spain.
  • Paez-Guillán E; Internal Medicine Department, University Hospital of Santiago de Compostela, A Coruña, Spain.
  • Novo-Veleiro I; Internal Medicine Department, University Hospital of Santiago de Compostela, A Coruña, Spain.
  • Pose-Reino A; Internal Medicine Department, University Hospital of Santiago de Compostela, A Coruña, Spain.
PLoS One ; 16(10): e0258602, 2021.
Article en En | MEDLINE | ID: mdl-34653221
BACKGROUND: Non-convulsive status epilepticus (NCSE) often goes unnoticed and is not easily detected in patients with a decreased level of consciousness, especially in older patients. In this sense, lack of data in this population is available. AIMS: The aim of the present study was to examine daily clinical practice and evaluate factors that may influence the prognosis of NCSE in non-epileptic medical inpatients. METHODS: We conducted a retrospective analysis including patients admitted by any cause in an Internal Medicine ward. All patients with compatible symptoms, exclusion of other causes, clinical suspicion or diagnosis of NCSE, and compatible EEG were included. Patients with a previous diagnosis of epilepsy were excluded. We also conducted a literature review by searching the PubMed/Medline database with the terms: Nonconvulsive Status OR Non-Convulsive Status. RESULTS: We included 54 patients, mortality rate reached 37% and the main factors linked to it were hypernatremia (OR = 16.2; 95% CI, 1.6-165.6; P = 0.019) and atrial fibrillation (OR = 6.7; 95% CI, 1.7-26; P = 0.006). There were no differences regarding mortality when comparing different diagnosis approach or treatment regimens. Our literature review showed that the main etiology of NCSE were neurovascular causes (17.8%), followed by antibiotic treatment (17.2%) and metabolic causes (17%). Global mortality in the literature review, excluding our series, reached 20%. DISCUSSION: We present the largest series of NCSE cases in medical patients, which showed that this entity is probably misdiagnosed in older patients and is linked to a high mortality. CONCLUSION: The presence of atrial fibrillation and hypernatremia in patients diagnosed with NCSE should advise physicians of a high mortality risk.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Estado Epiléptico / Hipernatremia / Pacientes Internos Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2021 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Estado Epiléptico / Hipernatremia / Pacientes Internos Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2021 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos