Abstracts

Status epilepticus (SE) is a medical emergency that occurs in roughly 100,000 to 160,000 individuals annually in the United States. The overall mortality of SE is about 20% and associated with approximately 55,000 deaths. The diagnosis of generalized convulsive status epilepticus (GCSE) could be readily made but can be challenging in nonconvulsive status epilepticus (NCSE). Although stat EEG is not available in all hospitals, EEG is the single most important study in NCSE diagnosis. Previous studies have shown that earlier treatment of SE typically resulted in a favorable outcome. We evaluated the overall utilization of stat EEGs and their usefulness in the diagnosis of NCSE., Records from stat EEGs were reviewed retrospectively from January to December 2005 at the Barrow Neurological Institute. Information regarding patient demographics, medical history, medications, indication for the study, ordering services, and EEG findings were collected by reviewing dictated reports. The data were then compiled on excel database for further analysis., Total of 110 stat EEGs were found out of more than 5000 EEGs performed in 2005. The patients[apos] age ranged from 5 days to 92 years old in 60 women and 50 men. The most common reason for ordering stat EEG was to rule out SE due to altered level of consciousness or previously witnessed seizures. Fifty-eight patients (52.7%) had the underlying condition of encephalopathy secondary to vascular or metabolic etiology. Other underlying conditions included intracranial hemorrhage (24.6%), tumor (14.5%), and traumatic brain injury (5.5%). Stat EEGs were ordered by multiple services including neurosurgery (35.5%), neurology (22.7%), pediatrics (16.4%), internal medicine (14.6%), emergency room (4.6%), and other services. The most common finding of stat EEG was abnormal pattern of diffuse or focal slowing and background suppression (85.5%). Discrete seizures but not SE were seen in 3 records. Ten records (9.1%) showed normal EEG patterns. Overall, 6 out of 110 records (5.5%) showed status epilepticus. Five out of 6 patients with SE were older than 50 years (range 22 to 80). Four patients had an underlying acute vascular lesion, one had a tumor, and another with sepsis. Two of 6 patients were already treated with anticonvulsants, and two additional patients with sedating medications. Remaining two patients had not been treated with anticonvulsants prior to their EEGs., Although the detection of SE on stat EEGs was infrequent, impact of such a finding can be significant in patient care. Two-third of our patients had not been adequately treated prior to their stat EEGs. SE was most commonly found among patients with acute intracranial lesions and age older than 50.,