Refractory status epilepticus: A developing country perspective

Sinha, Sanjib; Prashantha, D.K.; Thennarasu, Kandavel; Gs, Rao; Satishchandra, Parthasarathy

doi:10.1016/j.jns.2009.11.007

Cited by 14 publications

(22 citation statements)

References 37 publications

(52 reference statements)

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“…10,14 In this study, patients from Asia were younger; this could simply reflect the lower mean age of the Asian population. 10,14 In this study, patients from Asia were younger; this could simply reflect the lower mean age of the Asian population.…”

Section: Discussionmentioning

confidence: 84%

“…10,14,15 Observational studies are almost the only ones available in RSE, and the validity of such studies depends on the range of participation and the quality of their data. 10,14,15 Observational studies are almost the only ones available in RSE, and the validity of such studies depends on the range of participation and the quality of their data.…”

Section: Discussionmentioning

confidence: 99%

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Etiologies and characteristics of refractory status epilepticus cases in different areas of the world: Results from a global audit

et al. 2018

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To describe the demographics, etiologies, types of status epilepticus (SE), and outcomes in people with refractory and super-refractory SE from around the world, we prospectively collected cases of refractory SE (RSE) treated with continuous intravenous anesthetic drugs in an intensive care unit setting through online questionnaires using "active surveillance." We collected information about 776 cases of RSE in 50 countries over 4 years. Control of SE was achieved in 74% of the cases. Neurologic outcomes were poor in 41% of patients, and 24% died. Good outcome was associated with younger age and a history of epilepsy. Etiology strongly influenced the outcome. Patients from Asia were younger, more frequently presented with convulsive SE, and were more frequently affected by infectious etiologies when compared with patients from Europe and the Americas. Despite these differences, outcomes were similar in all countries. Demographics of patients with RSE in a global audit are similar to those in prior single center series, providing evidence of generalizability of those studies. Important differences exist among patients with RSE from different regions of the world, but these do not seem to significantly influence patient outcomes.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Etiologies and characteristics of refractory status epilepticus cases in different areas of the world: Results from a global audit

et al. 2018

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“…The cohort reported from the developing world significantly differs from the developed world (Neligan and Shorvon, ). Infectious aetiology accounts for the majority of cases of SE in developing countries (Visudtibhan et al ., ; Murthy et al , 2007; Chen et al ., ; Sinha et al ., ). However, in our series, remote symptomatic aetiology accounted for the majority of cases, but morbidity and mortality were noted to be higher in acute symptomatic SE compared to patients with remote aetiology ( table ).…”

Section: Discussionmentioning

confidence: 97%

“…We found that treatment delay was significantly higher in this part of the world (Mhodj et al ., ; Murthy et al , 2007; Sinha et al ., ). Only three patients (2.8%) reported for treatment within 30 minutes of SE, 9% within an hour, and 28% within three hours.…”

Section: Discussionmentioning

confidence: 97%

“…Age, level of consciousness at the time of admission, previous history of seizures, and EEG findings are some of the other variables shown to determine the outcome of SE (Neligan and Shorvon, ). The aetiology and time gap between onset of SE and initiation of treatment significantly differs in developing countries as compared to the western world (Mhodj et al ., ; Murthy et al ., ; Sinha et al ., ).…”

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confidence: 97%

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An audit of the predictors of outcome in status epilepticus from a resource‐poor country: a comparison with developed countries

Hassan

Rajiv

Menon

et al. 2016

Epileptic Disorders

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Aim. Status epilepticus is a neurological emergency with significant morbidity and mortality. This study describes the clinical profile, treatment, and predictors of outcome of status epilepticus in a tertiary referral centre in a developing country and aims to highlight the similarities and differences from data available from the western world. Methods. A retrospective analysis of data of patients treated for status epilepticus was conducted from prospectively maintained records, between January 2000 and September 2010. The demographic data, clinical profile and investigations (including neuroimaging and EEG), aetiology, treatment, and outcomes were studied and compared with data available from the western world. Results. The analysis included 108 events in 84 patients. A single episode of status epilepticus was treated in 72 patients (86%) and multiple status epilepticus events, ranging from two to six per patient, were managed in 12 patients (14%). Mean age was 24.1±20.3 years and 63% were males. The types of status epilepticus included convulsive status in 98 (90.7%), non‐convulsive status in seven (6.5%), and myoclonic status in three (2.8%). The majority of events (60%) were remote symptomatic, 16% were acute symptomatic, 16% were of unexplained aetiology, and 8% were progressive symptomatic. In 85 events (79%), status epilepticus could be aborted with first and second‐line drugs. The remaining 23 events (21%) progressed to refractory status epilepticus, among which, 13 (56%) were controlled with continuous intravenous midazolam infusion. Case fatality rate was 11%, neurological sequelae were reported in 22%, and 67% returned to baseline. Acute symptomatic status, older age, altered sensorium at the time of admission, and delayed hospitalisation were predictors of poor outcome. Conclusions. Aetiology was the most important determinant of outcome of status epilepticus, as in reports from the western world, with remote symptomatic aetiology secondary to gliosis being the most common. Treatment delay was frequent and adversely affected the outcome.

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Epilepsy, Status Epilepticus, and Refractory Status Epilepticus

Chen

2017

Refractory Status Epilepticus

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Refractory status epilepticus: A developing country perspective

Cited by 14 publications

References 37 publications

Etiologies and characteristics of refractory status epilepticus cases in different areas of the world: Results from a global audit

Etiologies and characteristics of refractory status epilepticus cases in different areas of the world: Results from a global audit

An audit of the predictors of outcome in status epilepticus from a resource‐poor country: a comparison with developed countries

Epilepsy, Status Epilepticus, and Refractory Status Epilepticus

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