Abstracts

Rationale: Data are limited regarding the yield of central nervous system imaging in newly presenting patients with status epilepticus with no prior history of seizures. Earlier reports have demonstrated up to 49% of brain imaging studies in status epilepticus may be abnormal. In a time where cost-containment needs strong consideration in medical practice, further data are required to determine a yield of abnormalities, particularly those that may alter care. Methods: The Status Epilepticus Project is an NIH sponsored epidemiology study with a database running continuously from 1989 through the present. 757 consecutive patients were identified presenting as status epilepticus in patients with no prior history of seizures. These patients were analyzed for each, gender, if an abnormality is present, further breakdown into acute structural abnormality such as stroke or hemorrhage, tumor, congenital abnormalities, hydrocephalus, etc. Results: Imaging was performed acutely in 757 patients. 455 of the 757 (60.1%), either initial CT or MRI, were abnormal. By age, in children one month to one year 15/34 (44.1%) were abnormal. In patients one year to 16 years of age 29/59 (49.2%) were abnormal. In the 16 year to 60 year group 124/161 (77%) were abnormal. In the over 60 year group 161/201 (80.1%) were abnormal. Conclusions: Patients undergoing acute central nervous system imaging with CT or MRI in status epilepticus patients with no prior history of seizures has a high yield with approximately 60% of studies abnormal. This is highest in the elderly. When the analysis is complete, further conclusions regarding the exact type of abnormality, whether there is a high probability of relationship to the cause of status epilepticus, whether it led to acute intervention will be discussed. Supported by NIH 1R01 NS051505-01A2