Incidence of status epilepticus in Rochester, Minnesota, 1965-1984

Hesdorffer, Dale C.; Logroscino, Giancarlo; Cascino, Gregory D.; Annegers, John F.; Hauser, W. Allen

doi:10.1212/wnl.50.3.735

Cited by 428 publications

(315 citation statements)

References 7 publications

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“…In the studies by Hesdorffer et al 10 in Rochester, USA and by Coeytaux et al 26 in Switzerland, more men than women were attended with status epilepticus (SE), however in the current study the percentages of men and women with this condition are practically equal. There was no statistical difference between the genders of patients who underwent emergency EEG for impaired consciousness to confirm non-convulsive status epilepticus.…”

Section: Resultscontrasting

confidence: 61%

“…The different patterns of EEG obtained in emergency patients, although nonspecific, can often be correlated with the etiology of diseases of the central nervous system such as trauma 4 , vascular injury and anoxic-ischemic injury due to cardiorespiratory arrest 5 . In hepatic encephalopathy 6,7 , Creutzfeldt-Jakob disease 8 , non-convulsive status epilepticus [9][10][11][12][13][14][15] and herpes simplex encephalitis 16 , EEG is decisive for diagnosis and thus guides therapy and gives an indication of the prognosis.…”

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confidence: 99%

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Emergency EEG: study of survival

Borges

Botós

Bastos

et al. 2010

Arq. Neuro-Psiquiatr.

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Objective: To determine the survival rate according to the main findings of emergency electroencephalography (EEGs) of patients treated in a tertiary hospital. Method: In this prospective study, the findings of consecutive emergency EEGs performed on inpatients in Hospital de Base in São José do Rio Preto, Brazil were correlated with survival utilizing KaplanMeyer survival curves. results: A total of 681 patients with an average age of 42 years old (1 day to 96 years) were evaluated, of which 406 were male. The main reasons for EEGs were epileptic seizures (221 cases), hepatic encephalopathy [116 cases of which 85 (73.3%) were men, p-value=0.001], status epilepticus (104 cases) and impaired consciousness (78 cases). The underlying disease was confirmed in 578 (84.3%) cases with 119 (17.5%) having liver disease [91 (76.0%) were men, p-value=0.001], 105 (15.4%) suffering strokes, 67 (9.9%) having metabolic disorders, 51 (7.5%) central nervous system infections and 49 (7.2%) epilepsy. In the three months following EEG, a survival rate of 75% was found in patients with normal, discreet slow activity or intermittent rhythmic delta activity EEGs, of 50% for those with continuous delta activity and generalized epileptiform discharges, and of 25% for those with burst-suppression, diffuse depression, and in alpha/theta-pattern coma. Death was pronounced immediately in patients with isoelectric EEGs. conclusion: The main findings of EEGs, differentiated different survival rates and are thus a good prognostic tool for patients examined in emergencies. Key words: EEG, emergency, prognosis, probability of survival.EEG de urgência: taxa de sobrevivência rEsuMO Objetivo: Determinar a taxa de sobrevivência (TS), segundo os principais achados de eletrencefalograma de urgência (E-EEG), dos pacientes atendidos nas emergências de hospital de alta complexidade. Método: Estudo prospectivo, por ordem de chegada, da correlação entre os achados de E-EEG, feitos nos pacientes à beira do leito, com TS, utilizando-se as curvas de sobrevidas de Kaplan Meyer no Hospital de Base de São José do Rio Preto, São Paulo/Brasil. resultados: Foram estudados 681 pacientes, dos quais 406 (59,6%) masculinos, com idade média de 42 anos (1 dia a 96 anos). As principais motivações para o E-EEG foram crises epilépticas (221 casos), encefalopatia hepática [(116 casos, dos quais 85 masculinos (73,3%), p= 0,001]; estado de mal epiléptico 104 e rebaixamento de consciência 78. O diagnóstico da doença de base foi confirmado em 578 (84,3%), sendo 119 (17,5%) hepatopatia, dos quais 91 (76,%) masculinos, p= 0,001; 105 (15,4%) acidente vascular encefálico; 67 (9,9%) distúrbio metabólico; 51 (7,5%) infecção do sistema nervoso central e 49 (7,2%) epilepsia. TS de 75% nos três primeiros meses foi encontrada nos pacientes com

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Section: Resultscontrasting

confidence: 61%

mentioning

confidence: 99%

Emergency EEG: study of survival

Borges

Botós

Bastos

et al. 2010

Arq. Neuro-Psiquiatr.

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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.…”

Section: Definitionsmentioning

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%

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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“…Acute symptomatic causes (i.e., stroke, metabolic, infectious, anoxic injury) tend to be more common than chronic causes (i.e., low antiepileptic drug level, alcohol abuse, tumor, remote effects from stroke) and are generally associated with a higher mortality. 2,5,14 Given the increasing Keywords ► seizures ► status epilepticus ► refractory status epilepticus ► epidemiology ► prehospital treatment ► diagnostic evaluation …”

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confidence: 99%

Current Trends in Treatment of Status Epilepticus and Refractory Status Epilepticus

Betjemann

2015

Semin Neurol

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Status epilepticus (SE) represents a common neurologic emergency that if not treated appropriately and in a timely fashion can lead to significant neurologic injury and mortality. A heterogeneous disorder, SE is often organized into major categories, including generalized convulsive SE (GCSE), focal motor SE, nonconvulsive SE (NCSE), and refractory SE. The treatment of SE and outcomes are often dictated by which type of SE a patient is experiencing, the age of the patient, and the underlying etiology. Despite significant advances in research, practice patterns vary and controversy remains regarding the most appropriate treatment of the various forms of SE. Epidemiology and PrognosisWhen broadly defined as a seizure lasting more than 30 minutes or recurrent seizures with incomplete return to baseline, the annual incidence of SE ranges from 10 to 41 per 100,000 persons, or roughly 125,000 to 195,000 new cases annually in the United States. 1-5 These figures may even be underestimates, particularly in the case of NCSE, which is only diagnosed through electroencephalographic (EEG) monitoring; recent studies of inpatient EEG monitoring, particularly in the intensive care unit (ICU), have demonstrated high rates of electrographic seizures that likely are underrecognized. 6-11 Owing in part to this increase in SE detection in the hospital, the incidence of SE is increasing. 12,13 Although greatly influenced by the etiology, overall mortality estimates related to SE approach 20% 1 and are not changing dramatically over time. 12,13 When considering the causes of SE, it can be helpful to divide cases into acute and chronic etiologies. Acute symptomatic causes (i.e., stroke, metabolic, infectious, anoxic injury) tend to be more common than chronic causes (i.e., low antiepileptic drug level, alcohol abuse, tumor, remote effects from stroke) and are generally associated with a higher mortality. 2,5,14 Given the increasing Keywords ► seizures ► status epilepticus ► refractory status epilepticus ► epidemiology ► prehospital treatment ► diagnostic evaluation AbstractStatus epilepticus is a heterogeneous disorder with varied definitions and presentations. Taken together, all forms of status epilepticus carry significant morbidity and mortality, much of which is dictated by the underlying etiology. Generalized convulsive status epilepticus, which represents a common form, is a true neurologic emergency that requires emergent management. Treatment focuses on stabilizing the patient and aggressive medical management to achieve the timely termination of seizures. For other forms of status epilepticus including nonconvulsive and focal status epilepticus, the goal remains early seizure termination, but the use of intravenous medications should be weighed against the risks associated with these therapies. The diagnostic evaluation of status epilepticus is guided by the patient's history and should be broad, including a screen for toxins, electrolytes, structural abnormalities, and central nervous system infectious and autoimmune/inflam...

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Incidence of status epilepticus in Rochester, Minnesota, 1965-1984

Cited by 428 publications

References 7 publications

Emergency EEG: study of survival

Emergency EEG: study of survival

Long‐term outcomes of status epilepticus: A critical assessment

Current Trends in Treatment of Status Epilepticus and Refractory Status Epilepticus

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