Incidencia del status epiléptico en el adulto: estudio epidemiológico prospectivo basado en población cautiva en Argentina

Romano, Lucas Martín; Spadaro, Esteban; Sousa, Leandro; Castellino, Griselda; Zorrila, Juan Pablo; Latini, M.; Abut, Pablo Álvarez; Ioli, Pablo; Gonorazky, Sergio Eduardo

doi:10.1016/s1853-0028(11)70005-2

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…9,10 Less is known about the epidemiology of status epilepticus in developing countries. Although studies are limited, the incidence of status epilepticus in Latin America is estimated to be approximately 24.3 per 100,000 people per year, 11 in Africa the incidence in children is approximately 35 per 100,000 people per year, 12 and in Asia it ranges between 4.6 and 5.5 per 100,000 people per…”

Section: Epidemiologymentioning

confidence: 99%

“…Less is known about the epidemiology of status epilepticus in developing countries. Although studies are limited, the incidence of status epilepticus in Latin America is estimated to be approximately 24.3 per 100,000 people per year, 11 in Africa the incidence in children is approximately 35 per 100,000 people per year, 12 and in Asia it ranges between 4.6 and 5.5 per 100,000 people per year 13 . However, the incidence of status epilepticus in low- and middle-income countries might be underreported because of the absence of electroclinical data necessary for diagnosing nonconvulsive status epilepticus.…”

Section: Epidemiologymentioning

confidence: 99%

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Emergent Management of Status Epilepticus

Rubinos

2024

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE Status epilepticus is a neurologic emergency that can be life- threatening. The key to effective management is recognition and prompt initiation of treatment. Management of status epilepticus requires a patient-specific–approach framework, consisting of four axes: (1) semiology, (2) etiology, (3) EEG correlate, and (4) age. This article provides a comprehensive overview of status epilepticus, highlighting the current treatment approaches and strategies for management and control. LATEST DEVELOPMENTS Administering appropriate doses of antiseizure medication in a timely manner is vital for halting seizure activity. Benzodiazepines are the first-line treatment, as demonstrated by three randomized controlled trials in the hospital and prehospital settings. Benzodiazepines can be administered through IV, intramuscular, rectal, or intranasal routes. If seizures persist, second-line treatments such as phenytoin and fosphenytoin, valproate, or levetiracetam are warranted. The recently published Established Status Epilepticus Treatment Trial found that all three of these drugs are similarly effective in achieving seizure cessation in approximately half of patients. For cases of refractory and super-refractory status epilepticus, IV anesthetics, including ketamine and γ-aminobutyric acid–mediated (GABA-ergic) medications, are necessary. There is an increasing body of evidence supporting the use of ketamine, not only in the early phases of stage 3 status epilepticus but also as a second-line treatment option. ESSENTIAL POINTS As with other neurologic emergencies, “time is brain” when treating status epilepticus. Antiseizure medication should be initiated quickly to achieve seizure cessation. There is a need to explore newer generations of antiseizure medications and nonpharmacologic modalities to treat status epilepticus.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Emergent Management of Status Epilepticus

Rubinos

2024

CONTINUUM: Lifelong Learning in Neurology

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Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia

Sandoval

Rio

Gómez

et al. 2020

Seizure

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The Status Epilepticus Severity Score (STESS) is one of the most well-known clinical scoring systems to predict mortality in status epilepticus (SE). The objective of this study was to validate STESS in a Colombian population. Method: We evaluated historical data of adult patients (age ≥16 years) with a clinical or electroencephalographic diagnosis of SE admitted between 2014 and 2017. Prospectively, we included patients admitted from January to June of 2018. The primary outcome was in-hospital mortality. Receiver operating characteristic (ROC)-analysis, determination of best cutoff values, sensitivity, specificity, and positive and negative likelihood ratios were performed. Results: The sample was 395 patients, with in-hospital mortality of 16.8 %. The area under the ROC curve for STESS was 0.84. A cutoff point of ≥3 produced the highest sensitivity of 84.9 % (95 % CI 73.9 %-92.5 %) and a specificity of 65.7 % (95 % CI 60.2 %-70.8 %), with a positive likelihood ratio of 2.5 and a negative likelihood ratio of 0.2. Conclusions: STESS is a useful tool to predict mortality in patients with SE. In Medellin, Colombia, a STESS < 3 allows the identification of the patients who survive reliably. Those patients with a score <3 may have a better prognosis, and treatment with fewer side effects than anaesthetics could be suggested, always remembering the importance of the treating physician's clinical judgement.

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Incidencia del status epiléptico en el adulto: estudio epidemiológico prospectivo basado en población cautiva en Argentina

Cited by 2 publications

References 27 publications

Emergent Management of Status Epilepticus

Emergent Management of Status Epilepticus

Validation of the Status epilepticus severity score (STESS) at high-complexity hospitals in Medellín, Colombia

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