Abstracts

Rationale: The application of video-EEG monitoring (VEEGM) in neuro-intensive care units (NICU) has allowed the recognition and treatment of non-convulsive status epilepticus (NCSE). Since this is an expensive and labor-intensive tool, very few centers in developing countries can use it. Therefore patient profile, management and outcome are rarely reported. We aimed to investigate the frequency of NCSE, clinical characteristics and prognosis of the patients who were monitored at the NICU of a tertiary referral center in Turkey. Methods: We retrospectivey reviewed the VEEGM reports of all patients who were monitored during November 2009-February 2012 at our adult NICU. Indications for VEEGM were mostly unexplained alterations of consciousness or witnessed convulsive seizures. We identified the clinical characteristics, treatment regimes and outcome of patients with NCSE and tried to determine which parameters were associated with prognosis. Results: NCSE was detected in 10/86 (11.6%) patients (3F,7M; age:24-72). Admission diagnoses were: stroke (3), epilepsy (3), limbic encephalitis (1), encephalitis-cardiac arrest (1), malignancy-reversible posterior leukoencephalopathy (1), hypoxic-ischemic encephalopathy (1). Two patients were also in sepsis. Three non-epileptic patients had witnessed seizures before VEEGM. At the onset of monitoring Glasgow coma scale (GCS) was <8 in 6 patients. Seven patients received IV anesthetics in addition to anticonvulsants. Three patients (1F, 2M; age: 51, 65 and 67; etiology: stroke, encephalitis-cardiac arrest and malignancy-reversible posterior leukoencephalopathy; GCS: <8 in two patients; IV anesthetics used in all) died in NICU. Conclusions: The frequency of NCSE in our NICU was about 10%, with 30% mortality rate. It was more common in males. There was a wide age range. Etiology was stroke or epilepsy in most patients. The most significant predictors of mortality seem to be male gender and etiology.