Abstracts

Rationale: Status epilepticus (SE) is defined as a seizure lasting ≥5 minutes or a series of seizures in rapid succession without complete neurological recovery to baseline. Little is known about demographic characterization of patients that develop SE in Mexico. The present study conveys relevant demographic characteristics and treatment outcomes in a large sample of SE patients treated in a large Neurological Center in Mexico City.

Methods: In this retrospective cross-sectional cohort we included patients 18 years old or older, with SE, recruited over a six-month period at the National Institute of Neurology and Neurosurgery in Mexico City. We compiled SE etiology, previous history of epilepsy, previous treatment of epilepsy, acute treatment of SE and outcomes utilizing conventional severity scales. Admission severity was calculated with Status Epilepticus Severity Score (STESS). Functional status at discharge was described using the modified Rankin scale (mRS).

Results: From June-December 2023, 553 were screened and 47 patients met our inclusion criteria. Twenty-seven were female (57.4%). The median age was 42 years [IQR 27-47]. Sixteen (34%) patients did not have history of epilepsy. SE was most frequently caused by infectious diseases (n=16, 34%), followed by Anti-Seizure Medication (ASM) discontinuation (n=5, 10.6%), and stroke (n=5, 10.6%). Fourteen patients (28.9%) had a history of previous SE. No patients in our sample were exclusively treated with first-line SE ASM, while 31 patients (65.9%) were successfully treated with second-line SE ASM. Only 11 patients (23.4%) underwent successful third-line SE treatment. Median hospital length of stay was 4 days [IQR 0.75-17], with 8 patients (17%) requiring admission to the Neurological Intensive Care Unit (NICU).The median NICU stay was 8 days [IQR2.25-22]. In-hospital mortality was reported in 4 patients (8.5%) (See Table 1). Thirty patients (63.8%) presented with a STESS of 0-2, 10 patients with a STESS of 3 (21.3%), and 6 patients ranging from 4-6 (12.7%). MRS was calculated at discharge: Twenty patients (42.55%) had a favorable neurological outcome (mRS 0-2), and 21 (44.6%) had significant neurological disability (mRS 3-5) (See Figure 1).

Conclusions: Data acquired from this cross-sectional study is consistent in etiology with published case series. Notably, no patients in our sample were exclusively treated with first-line SE ASM, depicting the third level complexity of the cases evaluated at our center. SE represents a notable neurological cause of morbimortality; although little is known about Mexican epidemiology for status epilepticus, our case series exemplifies our population demographics. Larger studies are required to better understand how SE presents within Latin American populations, a significantly under-represented cohort in medical literature.

Funding: Self-funded.