Epidemiology and Outcomes of Status Epilepticus

Abstract

Status epilepticus (SE) is a neurological and medical emergency, defined as a condition resulting either from the failure of the mechanisms responsible of seizure self-limitation or from the initiation of mechanisms which lead to atypically prolonged seizures. Further than death, SE can have long-term consequences, including neuronal injury, depending on the type, cause and duration of seizures with severe associated disabilities. In Europe, SE shows an incidence rate ranging about 9 to 40/100,000/y. In adults, mortality of patients with SE is ~30%, and even higher (up to 40%) in refractory status epilepticus. To date, etiology, duration, presence of comorbidity, level of consciousness, semiology and age are the main clinical predictors of SE outcome.

Seizure activity triggers tau hyperphosphorylation and amyloidogenic pathways

“…A generalized SE episode can constitute a risk factor for adverse neurophysiological sequelae 25,37 . The clinical relevance is high, considering that SE can be provoked by a plethora of acute injuries such as head trauma and stroke.…”

“…25,37 The clinical relevance is high, considering that SE can be provoked by a plethora of acute injuries such as head trauma and stroke. Although neuronal cell damage or loss following generalized SE is well documented, 13,25,37,38 the amyloidogenic and tau-related trajectories have been incompletely studied. Previously, increased BACE1 expression was reported 48 h after pilocarpine-induced SE, 39 modification of tau hyperphosphorylation occurred within hours after intraperitoneal KA, 40 and the production of Aβ-related peptide was enhanced 12 days after KA.…”

“…A generalized SE episode can constitute a risk factor for adverse neurophysiological sequelae. 25,37 The clinical relevance is high, considering that SE can be provoked by a plethora of acute injuries such as head trauma and stroke. Although neuronal cell damage or loss following generalized SE is well documented, 13,25,37,38 the amyloidogenic and tau-related trajectories have been incompletely studied.…”

Management of the first stage of convulsive status epilepticus in adults: a systematic review of current randomised evidence

“…Convulsive status epilepticus is the most severe form of epileptic attack and a life-threatening neurological emergency, which is associated with substantial mortality and morbidity [ 1 – 4 ]. The clinical manifestation of convulsive status epilepticus is characterised by a prolonged tonic–clonic seizure or repetitive seizures without full recovery of consciousness between them [ 2 , 5 , 6 ].…”

“…In Europe, the annual incidence of status epilepticus lies between 10 and 16 per 100,000 population, and convulsive status epilepticus accounts for 45–74% of all cases [ 7 – 9 ]. Incidence of convulsive status epilepticus tends to be higher in males than females [ 4 ]. Mortality of status epilepticus has been reported to range from around 8–33% according to aetiology, with older age being a detrimental factor [ 7 ].…”