Your browser doesn't support javascript.
loading
Electrographic seizure duration and inter-seizure intervals in focal status epilepticus.
Meletti, Stefano; Turchi, Giulia; Orlandi, Niccolò; Vaudano, Anna Elisabetta; Cioclu, Maria Cristina; Pugnaghi, Matteo; Giovannini, Giada.
Afiliação
  • Meletti S; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.
  • Turchi G; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy.
  • Orlandi N; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.
  • Vaudano AE; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.
  • Cioclu MC; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy.
  • Pugnaghi M; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.
  • Giovannini G; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy.
Epileptic Disord ; 25(4): 519-527, 2023 Aug.
Article em En | MEDLINE | ID: mdl-37170072
ABSTRACT

OBJECTIVE:

To characterize the duration of seizures and inter-seizure intervals in focal status epilepticus (SE).

METHODS:

We reviewed consecutive scalp EEG recordings from adult patients who were admitted for a first episode of focal status epilepticus. We identified electrographic seizure duration and inter-seizure intervals in the first diagnostic pretreatment EEG. We also reviewed isolated focal self-limiting seizures in epilepsy patients, as a comparison group for seizure duration.

RESULTS:

We recorded 307 focal seizures in 100 consecutive focal SE episodes, with a median seizure duration of 107 s (IQR 54-186), and 134 isolated focal self-limiting seizures in 42 epilepsy patients, with a median duration of 59 s (IQR 30-90; p < .001). The only clinical feature of SE that significantly increased seizure duration was acute symptomatic etiology. In SE, 15% and 7% of seizures lasted longer than 300 and 600 s, respectively (t1 of the actual definition for tonic-clonic and focal SE), while only 1% of self-limiting seizures lasted longer than 300 s, and none lasted longer than 600 s. The analysis of inter-seizure intervals in SE with multiple seizures showed that 50% of the inter-seizure periods were shorter than 60 s, and 95% were shorter than 540 s (9 min). Patients who had an increase in seizure duration (last versus first) of at least 1.4 times showed an increased 30-day mortality.

SIGNIFICANCE:

Focal seizures within a SE episode showed a wide range of duration, partly overlapping with the duration of focal self-limiting seizures but with a longer median duration. Inter-seizure intervals within an episode of SE were shorter than 1 min in 50% of the seizures and never lasted more than 10 min. Finally, an increase in seizure duration could represent an "electrophysiological biomarker" of a more severe SE episode, which may require more aggressive and rapid treatment.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estado Epiléptico / Epilepsia Parcial Contínua / Epilepsia Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estado Epiléptico / Epilepsia Parcial Contínua / Epilepsia Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article