Introduction: Status epilepticus is a neurological condition caused by a failure of body mechanism to terminate the seizures or the onset of abnormal seizure activity resulting in prolonged seizure’s duration for more than five minutes. The available research data on status epilepticus in Indonesia is still limited. The purpose of this study was to determine the profile of patients with status epilepticus at Sanglah General Hospital from 2020 to 2021. Methods: This was a descriptive study with a retrospective approach. The study populations were patients with status epilepticus who were treated at Sanglah General Hospital in 2019-2020 who had no missing data in the medical records. Results: There were 117 patients with status epilepticus, 63 males (53.8%) and 54 females (46.2%). There are 41 patients>60 years (35%), general onset in 63 patients (53.8%), and focal onset in 54 patients (46.2%). Etiology from cerebral was 68 patients (58.1%), followed by metabolic in 28 patients (23.9%). The most common OAE therapy was phenytoin (86.3%) and the longest length of stay status epilepticus patients was 8 days (55.6%). Patients with status epilepticus had leukocytosis (73.5%), increased NLR (66.7%), and decreased mean platelet volume (53.8%). Conclusion: The highest incidence of status epilepticus is in women, above 60 years, general onset type of seizure, and etiology from cerebral. Initial therapy in 117 patients was intravenous diazepam followed by phenytoin for maintenance. NLR increased in most of the patients showing signs of inflammation which further worsened the patient's outcome with a mortality rate of 47%. Keywords: Status epilepticus, seizure duration, anticonvulsant, neutrophil-lymphocyte ratio.
Background Psychogenic non-epileptic seizure (PNES) has long been the counterpart of epileptic seizure (ES). Despite ample of evidence differentiating the two, PNES mistakenly diagnosed as ES was still common, resulting in unnecessary exposure to long-term antiepileptic medications and reduced patient’s and caregiver’s quality of life, not to mention the burgeoning financial costs. Objectives In this review, we aimed to elucidate various differences between PNES and epileptic seizure with respect to baseline characteristics, seizure semiology, EEG pattern, and other key hallmark features. Methods An unstructured search was carried out in PubMed, MEDLINE, and EMBASE using keywords pertinent to PNES and ES differentiation. Relevant information was subsequently summarized herein. Results PNES differs significantly with ES in terms of baseline characteristics, prodromal symptoms, seizure semiology, presence of pseudosleep, and other hallmark features (for instance provoking seizure with suggestion). The combined approach, if applied appropriately, can yield high diagnostic yield. Conclusions PNES can be clearly differentiated from ES via careful adherence to a set of valid clinical cues. The summarized clinical hallmarks is highly useful to prevent unnecessary ES diagnosis and treatment with AEDs.
Introduction: Acute symptomatic seizures (ASS) are a type of neurological manifestation that occurs as a result of aberrant brain electrical activity triggered by intra- and extracranial stimuli. There is a shift in the clinical symptoms seen in the emergency department during this COVID-19 pandemic, which has an effect on the etiological profile of ASS. Materials and Methods: This research used a retrospective cross-sectional design. Between July 2020 and July 2021, a total of 80 patients fulfilled the inclusion criteria. Samples were collected at Sanglah Hospital, Denpasar Results: The data collected were 55% male (n=44) and 45% female (n=36). Patients ranged in age from 18 to 85 years, with a mean of 51 years. ASS is most prevalent in people aged 51-60 years (28,8%) and is least prevalent in those aged 18-20 years (7,5%). The worst outcome/death rate was 11,2 percent in the hypoxia, uremic, and stroke etiologic categories. Discussion: There was a paradigm change in the etiology of ASS during the COVID-19 pandemic. ASS is more prevalent in the 51–60 year age group. Consider the pathogenesis of ASS to be inducing hypoxia. Keywords: etiology profile, acute symptomatic seizures, seizures, COVID-19 pandemic.
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