Etiology and Clinical Outcomes of Status Epilepticus in Adults, Based on the New Definition

Abstract

Background: Status epilepticus (SE) is a common neurological emergency associated with a high morbidity and mortality rate. In 2015, the International League Against Epilepsy (ILAE) proposed a new status epilepticus (SE) definition. Objective: We aimed to apply the new definition of SE and analyze seizure types, clinical presentation, causes, complications, and predictors of the poor outcome based on the new definition. Method: 150 adult patients aged 18-90 years with SE in Vajira hospital between January 2016 and January 2019 were enrolled with a retrospective chart review of all. SE was defined and classified according to the ILAE 2015. Results: Out of 150 participants, 86 (57.3 %) were men with a mean age of 61.35 (±20.32) years. The acute symptomatic seizures were the most common causes, with 89.9%. The mortality rate was 48.7%. The clinical factors that statistically significantly affected the outcome were age, complications during admission, and low AEDs levels. Patients were 1.03 times higher for poorer outcomes per year increased in age (p-value 0.007, 95%CI 1.01-1.05), and 16.64 times higher (p-value < 0.001, 95%CI 4.65-59.63) among those with complications during the admission whereas the epilepsy patients who had low AED levels, which caused SE, were significantly found to have a better outcome. The common complications were a respiratory failure, pneumonia, and septicemia. Conclusion: According to the new definition of SE, older age and complications during the hospital stay have potential associated with poor neurological outcomes. In contrast, the epilepsy patient who had SE due to a low AEDs level seems to have a better prognosis. The acute symptomatic etiologies were still the most common cause of status epilepticus, and infection was supposed to be the most corresponding cause.