Valeur pronostique des anomalies IRM à la phase aiguë de l’état de mal épileptique inaugural de l’adulte

Etiological assessment of status epilepticus

“…They can be associated with cortical focal hyperperfusion (Figures 2B, 3B, 4A-B). Their prevalence is still not very well known: it ranges from 27.5% to 42.5% in two retrospective studies [128,129] and is equal to 37% in one prospective study [8]. A high correlation exists between clinical symptoms and EEG abnormalities.…”

“…In a prospective trial including 46 consecutive NOSEs [8], the etiology was acute symptomatic in 41%, remote symptomatic in 33% (including 80% vascular sequelae), progressive symptomatic in 15% and not identified in 8.7% of patients. Acute symptomatic cases gathered acute brain lesions with vascular etiology or of infectious or traumatic origin (20%), and alcohol withdrawal in alcoholic patients (10%), including 2 cases of SESA [101,102].…”

“…Acute symptomatic cases gathered acute brain lesions with vascular etiology or of infectious or traumatic origin (20%), and alcohol withdrawal in alcoholic patients (10%), including 2 cases of SESA [101,102]. Half of remote symptomatic cases were associated with acute factors triggering seizures (as in the patients with prior epilepsy detailed above) [8]. In another prospective trial conducted in 89 consecutive NOSEs [98], etiologies were acute symptomatic in 59 patients (66%; brain lesions in 41, toxic or metabolic disorders in 18), remote or progressive symptomatic in 17 and cryptogenic in 13.…”

“…In another prospective trial conducted in 89 consecutive NOSEs [98], etiologies were acute symptomatic in 59 patients (66%; brain lesions in 41, toxic or metabolic disorders in 18), remote or progressive symptomatic in 17 and cryptogenic in 13. Etiologies of NOSE in the main trials are summarized in Appendix 1 and Figure 1 [7,8,27,67,95,[103][104][105]. Most are linked to an acute etiology, either isolated or associated with a non-acute cause.…”

“…Therefore, each SE requires urgent treatment and represents a substantial proportion of the patients admitted to intensive care units (ICUs). Approximately half of the SE episodes occur in patients with epilepsy whereas the other half are inaugural and known as "de novo" or new-onset SE (NOSE) [1,2,[7][8][9][10]. In addition to the intrinsic gravity of the SE, etiology has a major influence on the prognosis [11].…”