Epidemiology and Risk Factors of Convulsive Status Epilepticus Patients Admitted in the Emergency Department of Tertiary Hospital in Mogadishu, Somalia

Abstract

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.

Poor Seizure Control Among Children Attending a Tertiary Hospital in South Western Uganda – A Retrospective Study [Letter]

“… 3 In addition, in this study we did not find any risk factors underlying the evaluation of epilepsy patients such as neurological examination, cerebral imaging, electroencephalographic findings, and laboratory tests including complete blood count and biochemical profile, all of which were assessed by a team of neurologists, pediatricians and emergency doctors. 3 …”

“…However, because the data obtained using medical records, it is difficult for researchers to determine matters related to the seizure onset, nature, and duration of the seizure when the patient comes to the hospital. 3 In addition, in this study we did not find any risk factors underlying the evaluation of epilepsy patients such as neurological examination, cerebral imaging, electroencephalographic findings, and laboratory tests including complete blood count and biochemical profile, all of which were assessed by a team of neurologists, pediatricians and emergency doctors. 3 The study conducted by Jane Namusisi et al was a retrospective review of charts, socio-demographic and clinical data obtained from medical records.…”

“…3 In addition, in this study we did not find any risk factors underlying the evaluation of epilepsy patients such as neurological examination, cerebral imaging, electroencephalographic findings, and laboratory tests including complete blood count and biochemical profile, all of which were assessed by a team of neurologists, pediatricians and emergency doctors. 3 The study conducted by Jane Namusisi et al was a retrospective review of charts, socio-demographic and clinical data obtained from medical records. Physical or telephone interviews were conducted with the patient's direct caregiver.…”

Central Neurocytoma Presenting with Progressive Headache: A Case Report and Literature Review

“…Tumor size, location, lesion extent, attachment to surrounding structures, vascularity, and surgeon experience play essential roles in resectability. When GTR is impossible, adjuvant radiosurgery and radiotherapy may be considered to improve tumor control (10,11).…”

Outcomes Of Women With Preeclampsia And Eclampsia Admitted In The Intensive Care Unit At A Tertiary Care Hospital In Mogadishu, Somalia.

“…Preeclampsia is a major risk for both early and late complications affecting both the mother and the infant. These complications include pulmonary thromboembolism, amniotic uid embolism, obstetric hemorrhage, sepsis, acute renal failure, postpartum cardiomyopathy and neurologic complications including cerebral venous thrombosis and intracerebral hemorrhage (12,23) . In this study, the death rate was so high among those with severe infections and acute renal failure.…”