Functional outcome after convulsive status epilepticus

Legriel, Stéphane; Azoulay, Élie; Resche-Rigon, Matthieu; Lemiale, Virginie; Mourvillier, Bruno; Kouatchet, Achille; Troché, Gilles; Wolf, Manuel; Galliot, Richard; Dessertaine, Géraldine; Combaux, Danièle; Jacobs, Frédéric; Beuret, Pascal; Mégarbane, Bruno; Carli, Pierre; Lambert, Yves; Bruneel, Fabrice; Bédos, Jean‐Pierre

doi:10.1097/ccm.0b013e3181f859a6

Cited by 119 publications

(122 citation statements)

References 45 publications

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“…In 21 studies including adults, definitions were more variable, including 30‐minute seizure duration limits,7, 8, 9, 10, 11, 12, 13 and 5‐minute clinical seizure duration or more than two seizures without return to baseline between seizures 14, 15, 16, 17, 18, 19. One study also chose a 10‐minute clinical seizure duration cutoff limit 20. Two studies reported patients with prolonged refractory SE, including patients with SE that persists or recurs over a period of ≥7 days after the initiation of continuous general anesthesia 21, 22.…”

Section: Definitionsmentioning

confidence: 99%

“…In mixed populations of adults and children, subsequent epilepsy after SE may occur in 22%‐41%,14, 30 which is less than in patients with history of RSE, who have a 87.5% risk of subsequent epilepsy 14. Only one adult study showed that 31% of patients have subsequent epilepsy or worsening of previous epilepsy after SE 20. The main predictor of subsequent epilepsy is the underlying SE etiology, and nonfebrile‐nonidiopathic,28 remote symptomatic,29 structural, and acute symptomatic (eg, anoxic brain injury)30 etiologies are usually associated with higher risk.…”

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

“…Long‐term mortality data after an episode of SE, including in‐hospital deaths, is 0%‐22% in children5, 6, 17, 26, 27, 28, 29, 33, 34, 35, 37, 38, 45, 53 and 0%‐57% in adults 10, 11, 12, 17, 19, 20, 43, 54…”

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

“…Age is one of the main outcome predictors after SE,53 with the youngest (<1 year)13, 28, 36, 38 and oldest11, 12, 20 patients having the poorest long‐term outcomes (>65 years11 or odds/risk ratio = 1.04‐1.05/year12, 20). The higher mortality reported in younger children may also reflect the higher proportion of acute symptomatic cases in this age group 63, 64, 65.…”

Section: Differences Between Adult and Pediatric Populationmentioning

confidence: 99%

“…In adults, etiologies associated with poor outcome include hypoxia,7, 8, 13 acute symptomatic,12, 20, 44, 45, 55 and progressive symptomatic causes 9, 12. In children, many studies have pointed out remote29, 35, 36 and acute6, 17, 24, 26, 71 symptomatic causes, progressive encephalopathies,17, 26, 35, 36 or more extensively “nonfebrile‐nonidiopathic SE”28 as predictors of poor outcome.…”

Section: Factors Affecting Outcomementioning

confidence: 99%

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Long‐term outcomes of status epilepticus: A critical assessment

et al. 2018

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SummaryWe reviewed 37 studies reporting long‐term outcomes after a status epilepticus (SE) episode in pediatric and adult populations. Study design, length of follow‐up, outcome measures, domains investigated (mortality, SE recurrence, subsequent epilepsy, cognitive outcome, functional outcome, or quality of life), and predictors of long‐term outcomes are summarized. Despite heterogeneity in the design of prior studies, overall risk of poor long‐term outcome after SE is high in both children and adults. Etiology is the main determinant of outcome, and the effect of age or SE duration is often difficult to distinguish from the underlying cause. The effect of the treatment on long‐term outcome after SE is still unknown.

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Section: Definitionsmentioning

confidence: 99%

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

Section: Differences Between Adult and Pediatric Populationmentioning

confidence: 99%

Section: Factors Affecting Outcomementioning

confidence: 99%

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Long‐term outcomes of status epilepticus: A critical assessment

et al. 2018

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Progressive Brain Atrophy in Super-refractory Status Epilepticus

et al. 2016

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IMPORTANCE Prolonged seizures in super-refractory status epilepticus (SRSE) have been shown to cause neuronal death and reorganization, and visual inspection in individual case studies has demonstrated progressive cortical and subcortical atrophy. At present, magnetic resonance imaging (MRI) studies that evaluate brain atrophy in SRSE are lacking. OBJECTIVES To document and quantify the development of atrophy over time in SRSE. DESIGN, SETTING, AND PARTICIPANTS This retrospective medical record review included all patients with SRSE who were admitted to a tertiary referral campus of the Mayo Clinic Hospital with SRSE from January 1, 2001, to December 31, 2013. Patients with (1) an initial MRI scan performed within 2 weeks of SRSE onset, (2) a second MRI scan within 6 months of SRSE resolution, and (3) a minimum duration of 1 week between MRI scans were included. The ventricular brain ratio (VBR) was measured on T2-weighted fluid-attenuated inversion recovery (FLAIR) images at disease onset and during follow-up. Measurements were performed on axial FLAIR images with section thickness of less than 5 mm. The plane immediately superior to the caudate head was chosen for analysis. The hypothesis that atrophy develops during SRSE despite seizure control (electroencephalogram background suppression with anesthetic drugs) was tested. Data were analyzed from June 1 to December 31, 2015. MAIN OUTCOMES AND MEASURES Change in VBR (ΔVBR) as a percentage of the starting measure. RESULTS Nineteen patients met the inclusion criteria; these included 10 men (53%) and 9 women (47%) with a median age of 41 (interquartile range [IQR], 25-68) years. Anesthetic agents were required for a median of 13 (IQR, 5-37) days. Initial MRI was performed a median of 2 (IQR, 1-7.5) days from the onset of SRSE, and the second MRI was performed a median of 11 (IQR, 5-15.5) days from the resolution of SRSE, with a median of 40 (IQR, 15-65) days between MRI scans. Median ΔVBR was 23.3% (IQR, 10.5%-70.3%). A significant correlation between the duration of anesthetic agent use and ΔVBR was found (Spearman r = 0.54; P = .02). CONCLUSIONS AND RELEVANCE Atrophy developed in all patients with SRSE who underwent serial imaging, despite administration of agents for seizure control. The degree of atrophy appears to be related to the duration of SRSE.

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Change in Mortality of Generalized Convulsive Status Epilepticus in High-Income Countries Over Time

et al. 2019

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IMPORTANCE Status epilepticus (SE) is associated with significant morbidity and mortality. Since the late 1990s, a more aggressive management of prolonged convulsive seizures lasting longer than 5 minutes has been advocated. OBJECTIVE To determine if convulsive SE mortality has decreased during a time of increasing advocacy for out-of-hospital treatment and escalating and earlier treatment protocols for prolonged seizures and SE. DATA SOURCE This systemic review and meta-analysis on studies focused on the mortality of convulsive status epilepticus was conducted by searching MEDLINE, Embase, PsychINFO,

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Functional outcome after convulsive status epilepticus

Cited by 119 publications

References 45 publications

Long‐term outcomes of status epilepticus: A critical assessment

Long‐term outcomes of status epilepticus: A critical assessment

Progressive Brain Atrophy in Super-refractory Status Epilepticus

Change in Mortality of Generalized Convulsive Status Epilepticus in High-Income Countries Over Time

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