SENSE registry for status epilepticus

Abstract

Evidence is scarce regarding the treatment of status epilepticus (SE). Only a few large randomized controlled trials have been published. Therefore, we set up a multicenter registry to prospectively document treatment practice in several different large hospitals in German-speaking countries. Over a period of more than 4 years, we were able to document 1179 episodes of 1049 patients who were treated for SE in 1 of the 8 participating centers in Germany, Austria, and Switzerland. Median age was 70 years. The most frequent etiology was remote (32%), followed by acute (31%), or a mixture of acute and remote factors (10%). Semiology was generalized convulsive in 44%, focal motor in 27%, and nonconvulsive in 30%. Only a few patients did not have relevant comorbidities. Median latency between SE onset and first treatment was 1 hour (median). Three hundred ninety-three (32%) of the patients were treated within 30 minutes after onset. The first treatment step consisted of benzodiazepines in more than 80%, and in levetiracetam in 15%. Five hundred eleven patients (49%) were refractory (defined as ongoing SE after application of benzodiazepine and 1 intravenous anticonvulsant). Further analysis of these registry data may be important for hypothesis generation and trial design for treatment of status epilepticus.

Factors predicting cessation of status epilepticus in clinical practice: Data from a prospective observational registry (SENSE)

“…). In addition, overall success rates of nonbenzodiazepine substances used in 50 or more patients were all between 38% and 44% …”

“…The methods and design of the SENSE registry have been published elsewhere . In brief, eight centers with special expertise in SE treatment in German‐speaking countries participated and recruited patients: Germany: Epilepsy Centre University Marburg, University Hospital Schleswig‐Holstein Campus Kiel, Klinikum Osnabrück, Krankenhaus Barmherzige Brüder Regensburg; Austria: Christian‐Doppler‐Klinik, Universitätsklinikum der Paracelsus Medizinischen Universität Salzburg, Department of Neurology, Innsbruck Medical University; Switzerland: University Hospital Basel, University Hospital Lausanne (the only French‐speaking site).…”

“…Therefore, a working group of centers from German‐speaking countries established a prospective registry for patients treated for SE, with the acronym SENSE (Sustained Effort Network for treatment of Status Epilepticus) . It includes data on all treatment stages reflecting clinical practice, which were evaluated to determine predictors of cessation of SE within the first hour (for generalized convulsive SE [GCSE]) and initial 12 hours (for non‐GCSE) of treatment.…”

Avoiding anaesthetics after multiple failed drug‐induced comas: an unorthodox approach to management of new‐onset refractory status epilepticus (NORSE)

“…To our knowledge, this approach for selected patients has not been reported before. The current mortality rate associated with NORSE and SRSE is high but variable between 23-60% and affected by the underlying aetiology and type of status (Gaspard et al, 2015;Hirsch et al, 2018;Kellinghaus et al, 2018). Autoimmune aetiologies tend to have lower mortality rates compared to structural aetiologies (Holzer et al, 2012;Alvarez and Drislane, 2016;Chen et al, 2018).…”

Factors predicting cessation of status epilepticus in clinical practice – data from a prospective observational registry (SENSE)

“…5,6 With the exception of the Veterans Affairs Study 4 Therefore, a working group of centers from German-speaking countries established a prospective registry for patients treated for SE, with the acronym SENSE (Sustained Effort Network for treatment of Status Epilepticus). 7,8 It includes data on all treatment stages reflecting clinical practice, which were evaluated to determine predictors of cessation of SE within the first hour (for GCSE) and initial 12 hours (for non-GCSE) of treatment.…”