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status epilepticus prognosis

María Sol Pacha, Lucas Orellana, Emanuel Silva, Glenda Ernst, Fatima Pantiu, Julieta Quiroga Narvaez, Ricardo Reisin, Oscar Martinez
Status epilepticus (SE) is a severe neurological condition with significant morbidity and mortality. A reliable tool for prognosis is needed to take decision regarding treatment strategies. We compared 2 available prognostic scores of outcome: the Status Epilepticus Severity Score (STESS) and the Epidemiology-based Mortality score in SE (EMSE). We included 46 patients with SE evaluated out the last 5years in our hospital. We excluded patients with postanoxic encephalopathy or incomplete data. Among the 46 patients with SE, in-hospital mortality was 28%...
October 10, 2016: Epilepsy & Behavior: E&B
Emel Oğuz-Akarsu, Zeynep Aydin-Özemir, Nerses Bebek, Candan Gürses, Ayşen Gökyiğit, Betül Baykan
Status epilepticus (SE) is rarely described in patients with juvenile myoclonic epilepsy (JME), and little is known about its frequency, subtypes, and predictors and the prognosis of these patients. In this retrospective study, we aimed to analyze the incidence of SE in patients with JME and emphasize the risk factors and long-term outcome of SE in an epilepsy outpatient-based cohort. We included patients with JME with a history of predominant myoclonic seizures and at least one diagnostic EEG with normal background activity and bursts of typical ≥3-Hz generalized spike-polyspike and waves...
October 10, 2016: Epilepsy & Behavior: E&B
Sharon Shmuely, Sanjay M Sisodiya, W Boudewijn Gunning, Josemir W Sander, Roland D Thijs
INTRODUCTION: Premature mortality is a major issue in Dravet syndrome (DS). To improve understanding of DS premature mortality, we conducted a comprehensive literature search with a particular emphasis on SUDEP. METHODS: We searched PubMed, Embase, Web of Science, Cochrane, CENTRAL, CINAHL, PsycINFO, Academic Search Premier, and ScienceDirect on the following terms: "Dravet syndrome", "severe myoclonic epilepsy", "SMEI", "mortality", "survivors", "prognosis", and "death"...
October 9, 2016: Epilepsy & Behavior: E&B
Alexandra Rohracher, Doris P Reiter, Francesco Brigo, Gudrun Kalss, Aljoscha Thomschewski, Helmut Novak, Alexander Zerbs, Judith Dobesberger, Aynur Akhundova, Julia Höfler, Giorgi Kuchukhidze, Markus Leitinger, Eugen Trinka
PURPOSE: Status epilepticus (SE) is one of the most common neurological emergencies with a high incidence in the elderly. Major determinants of prognosis are patients' age, duration of SE and underlying etiology. We aimed identifying differences in clinical presentation of SE, etiologies and outcome between patients (pts.) sixty years or older (≥60) and younger than sixty (<60) years (yrs). METHODS: We retrospectively analyzed 120 patients (48 women) with SE admitted to the Neurological Intensive Care Unit (NICU), Department of Neurology, Paracelsus Medical University Salzburg, Austria between 1/2011 and 01/2013...
August 22, 2016: Epilepsy Research
Gaurav Bhaskar Nigam, Sachin Suresh Babu, C Sudhir Peter, C Shobhna Peter
Predicting the neurological outcome in survivors of cardiorespiratory arrest is difficult. A distinction has been made between acute and chronic posthypoxic myoclonus, called myoclonic status epilepticus and Lance-Adams syndrome (LAS), respectively, with the acute condition carrying a bad prognosis. Here, we report a case of a 37-year-old female who developed seizures after a successful cardiopulmonary resuscitation. The available literature on such cases is very rare and has generally mentioned a poor outcome...
September 2016: Indian Journal of Critical Care Medicine
Yuichi Kubota, Hidetoshi Nakamoto, Takakazu Kawamata
Herein, we review the current state of nonconvulsive status epilepticus (NCSE). NCSE has recently been recognized as one of the causes of unexplained impaired consciousness in the neurosurgical or neurocritical setting. The causes of NCSE include not only central nervous system disorders such as craniotomy, stroke, traumatic brain injury, and central nervous system inflammation, but also severe critical conditions such as sepsis and uremia, among others. NCSE shows no overt clinical manifestations; therefore, prompt and correct diagnosis is difficult...
October 15, 2016: Neurologia Medico-chirurgica
Étienne de Montmollin, Sophie Demeret, Noëlle Brulé, Marie Conrad, Frédéric Dailler, Nicolas Lerolle, Jean-Christophe Navellou, Carole Schwebel, Mikaël Alves, Martin Cour, Nicolas Engrand, Jean-Marie Tonnelier, Eric Maury, Stéphane Ruckly, Géraldine Picard, Véronique Rogemond, Éric Magalhaes, Tarek Sharshar, Jean-François Timsit, Jérôme Honnorat, Romain Sonneville
RATIONALE: Encephalitis due to anti-N-methyl-D-aspartate receptor (NMDAR) antibodies is the leading cause of immune-mediated encephalitis. There is limited data on intensive care unit (ICU) management of these patients. OBJECTIVES: To identify prognostic factors of good neurologic outcome in patients admitted to an ICU with anti-NMDAR encephalitis. METHODS: Observational multicenter study of all consecutive adult patients diagnosed with anti-NMDAR encephalitis, admitted to an ICU between 2008 and 2014...
August 23, 2016: American Journal of Respiratory and Critical Care Medicine
M González-Cuevas, E Santamarina, M Toledo, M Quintana, J Sala, M Sueiras, L Guzman, J Salas-Puig
BACKGROUND AND PURPOSE: The severity of status epilepticus (SE) has an important impact in clinical outcomes. The Status Epilepticus Severity Score (STESS) is a score for predicting mortality in SE at admission. The baseline modified Rankin Scale (mRS) might be a prognostic factor for assessing the short-tem outcomes of SE. Therefore, our aim was to evaluate the effectiveness of mRS and whether its addition to the STESS improves the prediction of mortality. METHODS: Consecutive patients with SE and aged >16 years were recruited during 3 years...
October 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Kristin M Knudsen-Baas, Kjersti N Power, Bernt A Engelsen, Stig Erik Hegrestad, Nils Erik Gilhus, Anette M Storstein
PURPOSE: Epilepsy is common in glioma patients, but clinical data on the course of status epilepticus (SE) in this group are sparse. The aim of this study was to investigate the relationship of SE to tumor grading, seizure semiology, trigger factors, treatment response, recurrence and outcome of SE in patients with glioma. METHODS: Adult patients with SE and glioma WHO grade II-IV were identified from a prospective clinical study at two neurological departments...
August 2016: Seizure: the Journal of the British Epilepsy Association
M Fischer, E Schmutzhard
Posterior reversible encephalopathy syndrome refers to a neurological disorder characterized by headache, disorders of consciousness, visual disturbances, epileptic seizures, and subcortical vasogenic edema. About two thirds of patients develop neurological symptoms, which are associated with blood pressure fluctuations. One hypothesis is that hypertensive episodes cause autoregulatory failure, and values above the upper limit of cerebral autoregulation result in a breakthrough followed by hyperperfusion and blood-brain barrier dysfunction...
June 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
B de Toffol, K Kanemoto
Psychosis in epilepsy can be categorized in relation to seizures in two main categories: interictal psychosis and postictal psychosis. Postictal psychosis (PIP) is a specific syndrome in relation to seizure activity: a clear temporal relation exists between the psychotic state of sudden onset and a precipitating bout of complex partial or generalized seizures. However, this very specific syndrome is not included as such within the DSM-5, and PIP belongs to the category "Psychotic disorder due to another medical condition"...
May 16, 2016: L'Encéphale
Stephane Legriel, Gretchen M Brophy
The aim of this systematic review was to describe particularities in epidemiology, outcome, and management modalities in the older adult population with status epilepticus. There is a higher incidence of status epilepticus in the older adult population, and it commonly has a nonconvulsive presentation. Diagnosis in this population may be difficult and requires an unrestricted use of EEG. Short and long term associated-mortality are high, and age over 60 years is an independent factor associated with poor outcome...
2016: Journal of Clinical Medicine
Frank Besag, Giuseppe Gobbi, Albert Aldenkamp, Rochelle Caplan, David W Dunn, Matti Sillanpää
The categorisation of the childhood epilepsies into a number of different syndromes has allowed greater insight into the prognosis, not only with regard to seizure control but also in relation to cognitive and behavioural outcome. The role of genetics in determining both the syndrome and the behavioural outcome remains promising, although the promise is still largely unfulfilled. The behavioural/psychiatric outcome of a selection of the large number of childhood epilepsy syndromes is presented. The rate of autism in West syndrome, particularly in children who have tuberous sclerosis with temporal tubers, is high...
May 16, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
Aidan Neligan, Matthew C Walker
Status epilepticus (SE) is associated with significant mortality and accounts for ~10% of epilepsy-related deaths. Epilepsy and SE mortality data from 2001 to 2013, in addition to annual age group populations for England and Wales, were obtained from the Office of National Statistics website ( Age-adjusted mortality rates for epilepsy and SE with 95% confidence intervals (CIs) were calculated using the European Standard Population. Trends in mortality rates for both epilepsy and SE were investigated using the Spearman coefficient...
July 2016: Epilepsia
Amélia Mendes, Luísa Sampaio
PURPOSE: Status epilepticus (SE) is a neurological emergency with multiple etiologies and a complex pathophysiology, which is incompletely understood. Brain magnetic resonance imaging (MRI) represents a noninvasive tool to increase our knowledge about epileptogenesis. This paper aims to review the main MRI findings in SE. METHOD: We conducted a search in Medline database using the terms "MRI", "brain" and "status epilepticus" and further crossed for "diffusion-weighted image" (DWI), "perfusion", "spectroscopy", "susceptibility-weighted image" (SWI), "mortality", "morbidity" and "outcome"...
May 2016: Seizure: the Journal of the British Epilepsy Association
Cheng Huang, Ling Feng, Yao-Hua Li, Ying Wang, Xiao-Sa Chi, Wei Wang, Nan-Ya Hao, Dong Zhou, Lei Chen
PURPOSE: To investigate the characteristics and prognosis of epilepsy amongst older people hospitalized in southwestern China with newly diagnosed epilepsy. METHODS: We prospectively enrolled people older than 65 years who were admitted to a tertiary epilepsy center in West China between January 2008 and January 2013. Participants were divided into early-onset group (those who had a first seizure before age of 65) and late-onset group (those in whom the first seizure occurred after age of 65)...
May 2016: Seizure: the Journal of the British Epilepsy Association
Raoul Sutter, Saskia Semmlack, Peter W Kaplan
Nonconvulsive status epilepticus (NCSE) is a state of continuous or repetitive seizures without convulsions. Owing to the nonspecific symptoms and considerable morbidity and mortality associated with NCSE, clinical research has focused on early diagnosis, risk stratification and seizure termination. The subtle symptoms and the necessity for electroencephalographic confirmation of seizures result in under-diagnosis with deleterious consequences. The introduction of continuous EEG to clinical practice, and the characterization of electrographic criteria have delineated a number of NCSE types that are associated with different prognoses in several clinical settings...
May 2016: Nature Reviews. Neurology
Yukiko Motojima, Michiaki Nagura, Yoshitaka Asano, Hiroshi Arakawa, Eiko Takada, Yoshio Sakurai, Koichi Moriwaki, Masanori Tamura
BACKGROUND: Acute encephalopathy is disease with the possibility of sequelae. While early treatment is required to prevent the development of sequelae, a differential diagnosis is of utmost priority. Then we have investigated the parameters that can be applied to make early diagnosis and predict prognosis of acute encephalopathy. METHODS: We reviewed the medical charts of the inpatients from 2005 to 2011 and found out that 33 patients attended to our institute because of febrile status epilepticus...
March 31, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Stephen Hantus
PURPOSE OF REVIEW: Epilepsy emergencies include acute repetitive seizures and status epilepticus. Their prognosis depends on the etiology of the seizures and the time spent in status epilepticus. This review discusses the current perspective on the diagnosis and treatment of status epilepticus and acute repetitive seizures in the intensive care unit. RECENT FINDINGS: Current data on the treatment of status epilepticus emphasize early treatment over the choice of antiepileptic drug...
February 2016: Continuum: Lifelong Learning in Neurology
Carey A Wilson
Non-convulsive seizures (NCS) are common among critically ill children with acute encephalopathy. Continuous electroencephalogram (CEEG) monitoring is an indispensable tool to detect NCS, which is essential to guiding management and assessing prognosis. Risk factors for NCS are highest in pediatric intensive care unit (PICU) patients with altered mental status (AMS) and a recently witnessed clinical seizure, acute changes on neuroimaging, and/or interictal abnormalities on CEEG. Screening for at least 24 hours in at risk pediatric populations is ideal, but around half of NCS may be detected within the first hour...
October 2015: Transl Pediatr
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