Current treatment of status epilepticus in a single epilepsy unit.
Abstract number :
3.210
Submission category :
4. Clinical Epilepsy
Year :
2011
Submission ID :
15276
Source :
www.aesnet.org
Presentation date :
12/2/2011 12:00:00 AM
Published date :
Oct 4, 2011, 07:57 AM
Authors :
G. Javier, E. Santamarina, M. Toledo, M. Quintana, M. Sueiras, A. Rovira, S. Sarria-Estrada, X. Salas-Puig
Rationale: Nowadays the treatment of status epilepticus (SE) is controversialy. We try to describe the current management and prognostic of the SE in an epilepsy unit. Methods: We retrospectively selected the SE who were evaluated consecutively for the epilepsy unit of our center between January-2010 and June-2011. We recorded demographics, clinical and the results of the complementary studies carried out during the SE and during the follow-up. We analyzed the data by dividing two main groups: convulsive SE (CSE) and non-convulsive (NCSE).Results: We recruited 45 patients: Age 60 ( 20) [23-88] years-old. Male 54%. CSE represented 73%. Neuroimaging showed more lesional epilepsies in patients with NCSE (83%) as compared with CSE (62%). Initial drug used in CSE was benzodiazepine, followed by Levetiracetam and Valproate as a second drug. Conversely , the NCSE was treated with benzodiazepines (54%) or levetiracetam (25%) as the initial drug, and other antiepileptic drugs in an equal proportion. Sedation or intubation was required for control of 55% of the CSE compared to 25% of the NCSE. In both groups about 66% of patients were controlled within 72 hours. The direct mortality associated with the SE was seen in six patients belonging to the CSE subtype. Conclusions: SE controlled by an epilepsy unit are more likely elders and have symptomatic epilepsy. Benzodiazepines remain the first choice in treating whatever type of SE, however Levetiracetam has positioned as a second alternative for CSE or even a first line treatment for some cases of NCSE. The risk of sedation and direct mortality associated with SE is more likely observed in cases of CSE
Clinical Epilepsy