Clinical features and outcomes of nonconvulsive status epilepticus in a developing country: A 5-year retrospective study

Andal, Vida Margarette de Vera; Espiritu, Adrian I.; Geronimo, M.A.; Salonga-Quimpo, Rhea Angela M.; Gosiengfiao, Katerina Tanya P.; Fernandez, Marc Laurence L.

doi:10.1016/j.yebeh.2020.107547

Cited by 3 publications

(6 citation statements)

References 27 publications

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“…36 In developing countries, similar etiologies have been reported. 22 In our study, the main etiology was cryptogenic (56%), followed by neuroinfections (22.4%), and cerebrovascular disease ranked fourth among the etiologies (6.7%). The most common etiology reported in people newly diagnosed with epilepsy is cryptogenic (17.5 cases per 100,000 per year), 37 and therefore, it could be the reason we found a high number of patients with NCSE of cryptogenic etiology, considering 71% of our patient had a history of epilepsy.…”

Section: Discussionmentioning

confidence: 51%

“…21 In Asiatic developing countries, the percentage of NCSE in a few cohorts published ranged from 1.5% to 26%. 6,7,22 In Latin America, previous studies from Argentina and Peru found an incidence of 24.3 per 100,000 persons per year for SE, of which 48% belong to NCSE. 10,11 A previous small clinical series performed in Mexico City included nine patients, and NCSE was reported in 20% of them.…”

Section: Discussionmentioning

confidence: 98%

“…23 Interestingly, the prevalence of NCSE published in cohorts from developed and developing countries is similar. 22 It is estimated that up to 40% to 53% of SE are nonconvulsive, of which 16% to 43% are focal impaired awareness, whereas only 1% to 6% are generalized or absence status. 20 In the intensive care units, the prevalence of NCSE is 8% to 37% of critically ill patients in coma and constitutes up to 36% of emergency consultations in patients with an altered state of consciousness.…”

Section: Discussionmentioning

confidence: 99%

“…However, the inclusion of our patients reflects the daily routine of a clinical neurophysiology department in the diagnosis of NCSE, primarily using routine EEG similar to other series from developing countries. 6,7,22 Regarding the key clinical manifestation to suspect NCSE, altered consciousness (74%-82%) is the main clinical manifestation at the diagnosis of NCSE, 13,27,28 followed by speech disturbance (15%), altered behavior (11%), myoclonus or extrapyramidal symptoms (13%), catatonia (7%), or psychiatric symptoms (8%). 20 Our patients showed a similar proportion with different levels of altered consciousness (82.1%); among which coma represented 27.7% of all patients.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nonconvulsive Status Epilepticus: Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico

San-Juan

Ángeles

González-Aragón

et al. 2022

Journal of Clinical Neurophysiology

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There is a lack of clinical and epidemiological knowledge about nonconvulsive status epilepticus (NCSE) in developing countries including Mexico, which has the highest prevalence of epilepsy in the Americas. Our aim was to describe the clinical findings, EEG features, and outcomes of NCSE in a tertiary center in Mexico.Methods: We conducted a retrospective case series study (2010-2020) including patients ( $ 15 years old) with NCSE according to the modified Salzburg NCSE criteria 2015 with at least 6 months of follow-up. We extracted the clinical data (age, sex, history of epilepsy, antiseizure medications, clinical manifestations, triggers, and etiology), EEG patterns of NCSE, and outcome. Descriptive statistics and multinomial logistic regression were used.Results: One hundred thirty-four patients were analyzed; 74 (54.8%) women, the total mean age was 39.5 (15-85) years, and 71% had a history of epilepsy. Altered state of consciousness was found in 82% (including 27.7% in coma). A generalized NCSE pattern was the most common (32.1%). The NCSE etiology was mainly idiopathic (56%), and previous uncontrolled epilepsy was the trigger in 48% of patients. The clinical outcome was remission with clinical improvement in 54.5%. Multinomial logistic regression showed that the patient's age (P ¼ 0.04), absence of comorbidities (P ¼ 0.04), history of perinatal hypoxia (P ¼ 0.04), absence of clinical manifestations (P ¼ 0.01), and coma (P ¼ 0.03) were negatively correlated with the outcome and only the absence of generalized slowing in the EEG (P ¼ 0.001) had a significant positive effect on the prognosis.Conclusions: Age, history of perinatal hypoxia, coma, and focal ictal EEG pattern influence negatively the prognosis of NCSE.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nonconvulsive Status Epilepticus: Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico

San-Juan

Ángeles

González-Aragón

et al. 2022

Journal of Clinical Neurophysiology

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Prevalence, electroclinical spectrum and effect on the outcome of non-convulsive status epilepticus in critically ill patients; the utility of routine electroencephalogram

Zafar¹

2023

Epilepsy & Behavior

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Autoimmune Encephalitis in the Philippines: A Scoping Review on the Treatment Gaps, Challenges, and Current State of Care

2022

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ObjectivesWe reviewed the current health service delivery for individuals with Autoimmune Encephalitis (AE) in the Philippines and to identify the gaps and challenges in its management.MethodologyWe conducted a scoping review of pertinent literature AE in the Philippines using the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. We extracted data on epidemiology, legislation, health financing, information systems, pharmacotherapy, and healthcare services related to the management of AE in the local setting.DiscussionThe epidemiology of AE is still unknown. Out-of-pocket expenses contribute to most of the healthcare expenditure despite government-led programs to reduce the financial burden. The access to diagnostic examinations such as magnetic resonance imaging, electroencephalogram, and antibody testing is limited by the geographic distribution of the facilities and costs. The acute and long-term management of AE are cost-prohibitive and are not readily available. There are significant treatment gaps in the care of individuals with AE in the Philippines in terms of disease recognition, resource allocation, access to satisfactory diagnostic evaluation, and provision of prognosis-changing therapeutics. We proposed core strategies that can address these treatment gaps such as increasing awareness, improving access to health resources, adequate healthcare financing, and availability of support systems.

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Clinical features and outcomes of nonconvulsive status epilepticus in a developing country: A 5-year retrospective study

Cited by 3 publications

References 27 publications

Nonconvulsive Status Epilepticus: Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico

Nonconvulsive Status Epilepticus: Clinical Findings, EEG Features, and Prognosis in a Developing Country, Mexico

Prevalence, electroclinical spectrum and effect on the outcome of non-convulsive status epilepticus in critically ill patients; the utility of routine electroencephalogram

Autoimmune Encephalitis in the Philippines: A Scoping Review on the Treatment Gaps, Challenges, and Current State of Care

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