Outcome prediction in patients with acute repetitive seizures: Application of the Status Epilepticus Severity Score

Abstract

Acute repetitive seizures (ARS) pose a risk of hospital admission with status epilepticus and a mortality threat, which underscores the need for the early prediction of a clinical course. Unfortunately, little attention has been given to ARS in this context, even though we possess the appropriate predictive tools for the stages of status epilepticus. Therefore, the main aim of this study was to assess the prognostic value of the Status Epilepticus Severity Score (STESS) in the population of patients with ARS. The study included a population of 200 patients. Almost half of the patients had achieved seizure cessations after diazepam administration, whereas 19.5% progressed to status epilepticus despite antiepileptic drug treatment. Mortality reached 10.5% of the total population. The receiver operating characteristic (ROC) curve for prediction of death by the STESS had an area under the curve (AUC) of 0.901, with an optimal cutoff point for discrimination ≥2 (sensitivity 0.95, specificity 0.71, and Youden index 0.66). Hosmer-Lemeshow indicated good calibration of the STESS (chi-square goodness-of-fit test = 3.24; P = .919). The study shows excellent effectiveness of the STESS in the prognosis of the clinical course in patients with ARS. STESS may be a valuable tool for the proper planning of diagnostic and therapeutic activities in this population.

Parenteral Long-Acting Antiseizure Medications Are Used More Often to Treat Seizure Clusters Than Convulsive Status Epilepticus in the Pediatric Emergency Department

“…The Status Epilepticus Severity Score, recently shown to be applicable to seizure clusters as well, may be a valuable tool for this purpose. 48 Several studies have examined the administration of intravenous antiseizure medication for seizure control. In the past, only small retrospective studies on the efficacy and safety of secondline agents such as levetiracetam, phenytoin, sodium valproate and phenobarbital for treatment of both status epilepticus and seizure clusters were available.…”

“…The Status Epilepticus Severity Score, recently shown to be applicable to seizure clusters as well, may be a valuable tool for this purpose. 48…”

Intravenous ganaxolone for the treatment of refractory status epilepticus: Results from an open‐label, dose‐finding, phase 2 trial

“…Patients were administered the Status Epilepticus Severity Score (STESS) 44 and the Clinical Global Impression‐Severity (CGI‐S) scale 45 at baseline. STESS is a prognostic score relying on four outcome predictors (age, history of seizures, seizure type, and extent of consciousness impairment).…”

“…Patients were administered the Status Epilepticus Severity Score (STESS) 44 and the Clinical Global Impression-Severity (CGI-S) scale 45 F I G U R E 2 Modeled pharmacokinetic curves for all dose groups. The initial bolus of IV GNX resulted in rapid plasma GNX levels (~900 ng/ml), designed to terminate SE.…”

Convulsive status epilepticus management in adults and children: Report of the Working Group of the Polish Society of Epileptology

“…For many years the PSE has promoted the highest standards of medical care. However, there are few updated papers on management and treatment of SE in Polish literature [1][2][3][4].…”