Introduction Status epilepticus (SE) is one of the most common neurologic emergencies and is associated with significant morbidity and mortality. The underlying cause of SE varies between patients with epilepsy and those presenting without. The aim of this study was to evaluate the epidemiology, risk factors and outcomes of patients presenting with convulsive SE in the emergency department (ED) of a tertiary hospital in Mogadishu. Methods This was a cross-sectional study conducted between July 2021 and June 2022. The study included both patients with epilepsy and those without epilepsy presenting to the ED with SE. Risk factors and underlying etiologies were evaluated in the patients in both the pediatric group (0–18 years) and adult group (18 years and above). Clinical history, neurologic examinations, neuroimaging, electroencephalography findings, and laboratory investigations were all evaluated. Results The mean age for pediatric patients was 6 (SD±4.7), while the mean age for adult patients was 38 (SD±10.4). About 33 (36%) of the subjects had previous history of epilepsy, while 59 (64%) presented to the ED with their first seizure. About 80 (87%) had generalized seizure while 12 (13%) had focal seizure. Poor antiepileptic compliance was the most common risk factor for SE 20 (21.7%), followed by CNS infections 14 (15%), and prolonged febrile seizures 7 (7.6%). Poor antiepileptic drug compliance, cerebrovascular disorders, electrolyte imbalance, metabolic conditions, and drug abuse were the most common underlying etiologies of SE in patients older than 18 years. Prolonged febrile seizure, meningitis, encephalitis, systemic infections, and structural brain abnormalities were the most common underlying etiologies of SE in patients younger than 18 years. Conclusion CNS infections, CVDs, metabolic disturbances, electrolyte imbalances, and systemic infections are major etiological risk factors of SE in patients without prior history of epilepsy. Medication adherence was the major etiological risk factor for SE identified in patients with epilepsy.

Central neurocytoma (CN) is a rare benign brain tumor primarily diagnosed in young patients. It mainly occupies the lateral ventricle and has relatively characteristic imaging features that aid in its diagnosis. This tumor causes obstructive hydrocephalus and manifests with signs of increased intracranial pressure. Herein, we present a case of a 53-year-old female diabetic patient who presented to our neurology clinic with an eight-month history of diffuse progressive headaches. Her headache was associated with nausea but not vomiting. There was no motor or sensory deficits or paresthesia. Likewise, the examination revealed no diplopia, ophthalmoparesis, cranial nerve impairments, or papilledema. Magnetic resonance imaging (MRI) of the brain revealed a heterogeneous intraventricular mass measuring 45x41 mm in size with surrounding mild tissue edema, typical for a central neurocytoma. The patient was referred to the neurosurgery department for surgical removal of the tumor; however, the patient did not consent to surgery. Brain MRI should be done in young patients with a headache that does not have the characteristics of primary headaches.

More than 50 million individuals worldwide suffer from epilepsy, and concomitant conditions including decreased renal function can make managing the condition more difficult. It has been proven in many studies that the probability of convulsions is high in patients with kidney failure. Clinicians must understand how antiepileptic medications (AEDs) are influenced by decreased renal function and how epilepsy management strategies are affected by the kidneys in order to maximize epilepsy control in patients with kidney illness. On the otherhand, seizures are brought on in patient with renal failure by the buildup of toxins as well as by other conditions such as sepsis, hemorrhage, malignant hypertension, metabolic disturbances, and electrolyte abnormalities, acute dysequilibrium syndrome. Some antibiotics lower convulsive thresholds, putting patients at risk for status epilepticus. A thorough understanding of AED metabolism, their pharmacokinetic alterations in such disorders, careful use of concurrent drugs, and monitoring of AED serum levels are all necessary for effective seizure management in renal diseases. We wanted to remind the problems we face as clinicians and their solutions by reviewing the articles related to this review.