Abstracts

Rationale: Status epilepticus (SE) is often associated with brain injury such as stroke and although it is thought to be epileptogenic in acute symptomatic etiology, it is not clearly associated with the development of poststroke epilepsy (PSE). Moreover SE is infrequently reported in PSE series and their consequences taking into account the timing of SE after stroke remains to be discussed. The aim of the present study was to investigate the outcome of the patients with poststroke SE according to the timing after the stroke Methods: All SE patients in our center are prospectively collected in a database since February 2011; for this purpose we selected all patients with stroke as etiology (ischemic and hemorrhagic). We assessed demographics, previous history of epilepsy, type of SE, level of consciousness, mSTESS, duration of SE, refractoriness, and type of stroke, location; regarding to outcome we collected the outcome at discharge, at last follow-up and the occurrence of epilepsy in non-previously epileptic patients. Results: We evaluated 95 poststroke SE: 54 ischemic (44 affecting MCA) and 41 hemorrhagic (28 lobar ICH). 40 (42.1%) were female. Mean age: 72.7 +/- 13.56 years old. 33(34.7 %) had a previous history of epilepsy. 51 (53,7%) showed prominent motor symptoms. 49 (51.6%) needed > 2 AEDs and 27 (28.4 %) anesthetics for their treatment. The median duration was 12 hours (4-48). The median time between the stroke and SE was 15 days (0-532). Regarding the outcome at discharge, 34 patients (35.8%) fully recovered and the rest a bad prognosis:, 44 (46.3%) showed a functional decline and 17 (17.9%) died. Among survivors, 32.7% of non-previously epileptic patients developed PSE after a mean follow-up of 422 days. When analyzing outcome at discharge, after a logistic regression, the occurrence of SE within the 72 hours after the stroke onset (p=0.003) and baseline mSTESS (p=0.010) were the only factors predicting mortality. Considering together with the functional decline females (p=0.019), a low level of consciousness (p=0.051), a timing between stroke and SE below 90 days (p=0.0001) and a SE duration longer than 12 hours (p=0.011) remained as independent predictor for bad prognosis. We did not find any association with the type of SE or the stroke, Regarding the follow-up, apart from the occurrence of SE within the 72 hours after the stroke (p=0.0001) and baseline mSTESS (p=0.012), the SE duration (p=0.004) predicted the mortality at long-term. Among survivors, the only factors predicting the development of epilepsy were the recurrence of SE (p=0.037) and a timing over 15 days between the stroke and the SE (p=0.05). Conclusions: The timing of SE after stroke has different consequences in the patients with poststroke SE: mortality was clearly increased within the first 72 hours after a stroke whilst a clinical decline remains more possible in the first 3 months. Regarding the development of PSE, it was more likely when SE appears after 15 days of the stroke. Other factors as mSTESS and SE duration affects not only outcome at discharge but also at long-term in poststroke SE. Funding: No funding