Seizure: European Journal of Epilepsy
Volume 17, Issue 6 , Pages 535-548, September 2008

Status epilepticus in epileptic patients:

Related syndromes, precipitating factors, treatment and outcome in a video-EEG population-based study

  • C. Di Bonaventura

      Affiliations

    • Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Italy
    • Corresponding Author InformationCorresponding author at: Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Viale dell’Università 30, 00185 Rome, Italy. Tel.: +39 06 49914727; fax: +39 06 49914302.
    • ,
  • F. Mari

      Affiliations

    • Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Italy
    • I.R.R.C.S. Neuromed, Pozzilli (IS), Italy
    • ,
  • N. Vanacore

      Affiliations

    • National Centre of Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
    • ,
  • J. Fattouch

      Affiliations

    • Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Italy
    • ,
  • A. Zarabla

      Affiliations

    • Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Italy
    • ,
  • A. Berardelli

      Affiliations

    • Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Italy
    • I.R.R.C.S. Neuromed, Pozzilli (IS), Italy
    • ,
  • M. Manfredi

      Affiliations

    • Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Italy
    • I.R.R.C.S. Neuromed, Pozzilli (IS), Italy
    • ,
  • M. Prencipe

      Affiliations

    • Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Italy
    • ,
  • A.T. Giallonardo

      Affiliations

    • Department of Neurological Sciences, Policlinico Umberto I°, University of Rome “La Sapienza”, Italy
    • I.R.R.C.S. Neuromed, Pozzilli (IS), Italy

Received 3 April 2007; received in revised form 4 December 2007; accepted 29 February 2008. published online 09 April 2008.

Summary 

Introduction

Status epilepticus (SE) is frequently observed in epileptic patients. We reviewed a series of video-EEG documented SE to define the characteristics of SE in this population.

Materials and methods

Retrospective evaluation of 50 epileptic patients with SE, revision of the electro-clinical data and therapies, and definition of the semeiological subtypes, aetiology, outcome and related epileptic syndromes.

Results

We identified 28 convulsive (19 focal and 9 generalized) and 22 non-convulsive (8 focal and 14 generalized) SE patients. In 13 patients, SE was situation-related (poor compliance, AED reduction, worsening seizures).

In the remaining 37 patients, SE was related to the natural history of epilepsy (progression of underlying pathologies or intrinsic expression of epileptic syndromes); in these last cases, our results show a higher occurrence in cryptogenic frontal epilepsy (p=0.01). We identified two subgroups according to the duration of the event, i.e. SE lasting <12h and SE lasting >12h. Our results showed a worse response to therapy in SE lasting >12h (p=0.01), a better response to therapy in non-convulsive SE than in convulsive SE (p<0.05) and a relationship at statistical significance limit between a poor response to therapy/worse outcome and symptomatic epileptic syndromes (p=0.06).

Conclusion

SE in epileptic patients has a wide spectrum of electro-clinical features. It may be related to the withdrawal or reduction of AEDs, or may even be the expression of the evolution of epileptic syndromes. Response to therapy is dependent on early diagnosis and therapy.

Keywords: Epilepsy syndromes, Status epilepticus, Video-EEG

 

PII: S1059-1311(08)00052-6

doi:10.1016/j.seizure.2008.02.002

Seizure: European Journal of Epilepsy
Volume 17, Issue 6 , Pages 535-548, September 2008

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