IMPROVED SURVIVAL IN STATUS EPILEPTICUS PATIENTS WITH HISTORY OF SEIZURE
Abstract number :
3.260
Submission category :
Year :
2005
Submission ID :
5264
Source :
www.aesnet.org
Presentation date :
12/3/2005 12:00:00 AM
Published date :
Dec 2, 2005, 06:00 AM
Authors :
1Elizabeth J. Waterhouse, 1Linda K. Garnett, 2Viswanathan Ramakrishnan, 1Lawrence D. Morton, 1Alan R. Towne, and 1Robert J. DeLorenzo
Status epilepticus (SE) occurs in a variety of patients, including those with a prior history of seizures, as well as hospitalized patients with systemic or acute neurologic conditions. Because SE is associated with a high mortality, it is important to identify those groups of patients who are likely to have a relatively good prognosis for survival. The hypothesis for this study was that patients with a history of at least one prior seizure have shorter SE duration, and improved SE survival, compared with SE patients who have never had a seizure. We analyzed prospectively-collected data from the Greater Metropolitan Area Status Epilepticus Database, with 1099 patients available for review. We divided the study population into two groups. Group I patients had a history of one or more prior seizures, while Group II patients had no prior seizure history. These groups were compared in terms of age, sex, race, SE etiology, SE duration, and SE mortality. Mortality was defined as death within 30 days of SE. Slightly fewer than half (46.7%) of the study population had a previous seizure history. Group I patients were significantly more likely to be in the age group of 16 to 60 years (p[lt]0.0001), to have generalized convulsive SE (p[lt]0.02), and to have SE onset outside the hospital (p[lt]0.0001). Group I patients were significantly more likely to have an SE etiology of low antiepileptic drug level (OR 36.7), withdrawal (OR 3.76) or remote (OR 1.6), compared with Group II patients, who were more likely to have SE etiologies of CNS acute, non CNS acute, or hypoxia/anoxia (p[lt]0.0001). Group I patients had shorter SE durations than Group II. They were three times more likely to survive SE than Group II patients (10.9% vs. 32.7% mortality, respectively, p [lt] 0.0001). SE patients with previous seizure history have shorter SE duration and significantly improved SE survival, compared with non-seizure patients. This finding may have important implications for understanding physiological mechanisms of seizure termination (Supported by NIH P50 NS25630.)