Abstracts

Rationale: The objective of this study was to compare serum levels of sP-selectin and soluble intercellular adhesion molecule-1 (sICAM-1) between patients diagnosed with status epilepticus (SE) and healthy controls to test the hypothesis that inflammation plays a role in epileptogenesis, and to investigate whether these molecules might be potential biomarkers to predict the course and prognosis of SE.Methods: Fifty-five adult patients diagnosed with SE between February 2012 and December 2013 were included in the study. Clinical and demographic features of the patients were recorded; and all patients, excluding those who died within one month of SE, were followed for 13.6 ± 4.6 months. Serum sICAM-1 and sP-selectin levels were measured during SE or within 24 hours of SE, and compared to the 28 subjects in the control group.Results: Classification of patients based upon the SE subtype revealed generalized convulsive SE (GCSE) in 35 patients (63.6%), epilepsia partialis continua (EPC) in 12 patients (21.8%), and non-convulsive SE (NCSE) in 8 patients (14.5%). Thirteen patients (23.6%) were diagnosed with refractory SE (RSE). Early prognosis was good in 42 (76.4%) and poor in 13 (23.6%) patients, and late prognosis was good in 30 (54.5%) and poor in 25 (45.5%) patients. Etiological factors, in order of frequency, included tumors in 9 (16.4%), metabolic and toxic causes in 6 (11%), discontinuation of anti-epileptic drugs (AED) in 6 (11%), cerebrovascular events in 5 (9.1%) patients, and the etiology could not be determined in 8 (14.5%) patients. Serum sP-selectin levels were higher in SE patients compared to controls (P=0.026). Serum sICAM-1 levels were significantly higher in patients with EPC compared to patients with GCSE (P=0.022) and controls (P=0.03). Serum C-reactive protein (CRP) levels were not different between patients with EPC, NCSE, and GCSE (P=0.4).Conclusions: Higher levels of serum sP-selectin and sICAM-1 in SE patients compared to controls supports the hypothesis that inflammation plays a role in the pathogenesis of SE. sICAM-1 may be associated with the pathogenesis of EPC, in particular. However, no relationship could be established between these molecules and the prognosis and refractoriness of SE, and therefore it has been concluded that these molecules cannot be used as biomarkers of the prognosis of SE in clinical practice.