Comparison of clinical profile and outcome of de novo convulsive status epilepticus with those with a past history of epilepsy in the elderly populace.

ABSTRACT

AIM: To compare the clinical characteristics and etiological differences between de novo convulsive status epilepticus (CSE) with those with a past history of epilepsy in the elderly populace and the predictors of in-hospital mortality. METHODS: One hundred twenty-two elderly (≥60 years of age) hospitalized patients with CSE were evaluated for clinical profile, etiologies and predictors of in-hospital mortality. RESULTS: The mean age of the study population was 67.2±7.7 years. Among them, 77 (63.1%) cases were of de novo CSE and 45 (36.9%) cases had a past history of epilepsy. Most common etiologies in de novo CSE were acute symptomatic in 68.8%, followed by remote symptomatic in 24.7% of cases. Inhospital mortality in de novo CSE was 38.9 % and on multivariate analysis, it was found variables significantly related to mortality in CSE were the presence of comorbidities (odds ratio (OR) = 0.229, 95% confidence interval (CI) = 0.059- 0.897; p=0.03) low Glasgow Coma Scale (GCS) (OR =0.045 , 95% CI =0.013- 0.160 ; p= 0.01) and de novo CSE ( OR= 0.093, 95% CI = 0.017- 0.503 ;p= 0.01 ). CONCLUSIONS: De novo CSE in the elderly was associated with poorer outcomes in comparison to those with a past history of epilepsy. In-hospital mortality in CSE was related to the presence of comorbidities, low GCS and de novo CSE. Prompt and aggressive management of de novo CSE is the most effective way of preventing in-hospital mortality in the elderly.