Prognostic analysis of status epilepticus_Journal of Epilepsy

Authors：

LI Qi ¹ , WANG Xu ¹ , CHAO Lina ¹ , LIU Xiaojing ¹ , LIU Meili ¹ ,  ZHANG Qing ²

1. Department of Neurology, Shandong Second Provincial General Hospital, Ji'nan 250022, China;
2. Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan750000, China;

Corresponding author：

ZHANG Qing, Email: nxzhangqing@aliyun.com

Keywords：

Status epilepticus; Prognosis; Status epilepticus severity score scale

DOI：

10.7507/2096-0247.202212011

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Objective To study the factors that affect the prognosis of status epilepticus (SE) and to improve the understanding of clinicians. Methods A retrospective analysis of 57 patients with SE witch from the General Hospital of Ningxia Medical University and Cardio-cerebrovascular Disease Hospital were carried out to collect their clinical data. The data were analyzed by SPSS 17.0 software. The prognosis of the patients was assessed by the Status epilepticus severity score (STESS) scale. Results A total of 57 patients were included, 53 cases improved, 4 cases were automatically discharged. Telephone follow-up showed that 4 cases of automatic discharge were dead. The mortality rate of SE was 7.02%. The most common cause of SE was acute cerebrovascular disease (17.54%), followed by intracranial infection (10.53%); The most common incidence were the occasional medication, self-medication, withdrawal (15.79%). Age, state of consciousness and concurrent infection were associated with prognosis (improvement/death) (P<0.05). STESS score of 0 to 2 points were 45 patients, all improved; score of 3 to 5 points were 12 patients, 8 patients improved, 4 patients died. There were significant differences in the prognosis between the two groups (P<0.05). Conclusions Age, state of consciousness, concurrent infection were related to prognosis, more than 65 years, the state of consciousness for the sleeping or coma had the poor prognosis. STESS scale can predict the prognosis of patients effectively.

Citation： LI Qi, WANG Xu, CHAO Lina, LIU Xiaojing, LIU Meili, ZHANG Qing. Prognostic analysis of status epilepticus. Journal of Epilepsy, 2023, 9(3): 186-191. doi: 10.7507/2096-0247.202212011 Copy

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2.	De Lorenzo RJ, Pellock JM, Towne AR, et al. Epidemiology of statusepilepticus. Clin Neurophysiol 1995, 12: 316–325.
3.	Wu YW, Shek DW, Garcia PA, et al. Incidence and mortality of generalized convulsive status epilepticus in California. Neurology, 2002, 58: 1070-1076.
4.	Knake S, Hamer HM, Rosenow F. Status epilepticus: a critical review. Epilepsy Behav, 2009, 15: 10-14.
5.	Rossetti A O, Logroscino G, Milligan T A, et al. Status epilepticus severity score (STESS): a tool to orient early treatment strategy. Journal of Neurology, 2008, 255(10): 1561-1566.
6.	李海峰. 癫痫持续状态63例急诊救治体会. 中国实用神经疾病杂志, 2015, (16): 68-69.
7.	Dham BS, Hunter K, Rincon F. The epidemiology of status epilepticus in the united states. Neurocritical Care, 2014, 20(3): 476-483.
8.	Vignatelli L, Rinaldi R, Galeotti M, et al. Epidemiology of status epilepticus in a rural area of northern Italy: a 2-year population-based study. Eur J Neurol, 2005, 12(11): 897-902.
9.	Logroscino G, Hesdorffer DC, Cascino G, et al. Status epilepticus without an underlying cause and risk of death: a population-based study . Arch Neurol. 2008, 65（2）: 221-224.
10.	宿英英, 黄旭升, 潘速跃, 等. 惊厥性癫癎持续状态监护与治疗(成人)中国专家共识. 中国现代神经疾病杂志, 2015, 25(11): 25-31.
11.	Hussain N, Appleton R, Thorburn K. Aetiology, course and outcome of children admitted to paediatric intensive care with convulsive status epilepticus: a retrospective 5-year review. Seizure, 2007, 16(4): 305.
12.	Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. NeurocritCare, 2012, 17: 3-23.
13.	Mayer SA, Claassen J, Lokin J, et al. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Archives of Neurology, 2002, 59(2): 205-210.
14.	Walker MC. Status epilepticus in the intensive care unit. Neurol, 2003, 250: 401-406.
15.	冯鸽. 86例癫痫持续状态的临床分析. 吉林大学, 硕士学位论文, 2011.
16.	Wu HM, Huang CC, Chen SH, et al. Herpes simplex virustype 1 inoculation enhances hippocampal excitability andseizure susceptibility in mice. Eur J Neurosci, 2003, 18(12): 3294-3304.
17.	Tsakiri N, Kimber I, Rothwell NJ, et al. Mechanisms of interleukin-6 synthesis and release induced by interleukin-1and cell depolarization in neurones. Mol Cell Neurosci, 2008, 37(1): 110-118.
18.	Sugai K. Treatment of convulsive status epilepticus in infants and young children in Japan. Acta Neurol Scand, 2007, 115(4): 62-70.
19.	Betjemann JP, Lowenstein DH. Status epilepticus in adults. Lancet Neurology, 2015, 14(6): 615-624.
20.	Shneker BF, Fountain NB. Assessment of acute morbidity and mortality innonconvulsive status epilepticus. Neurology, 2003, 61: 1066-1073.
21.	Hocker S, Wijdicks EF, Rabinstein AA. Refractory status epilepticus: new insights inpresentation, treatment, and outcome. Neurol Res, 2013, 35: 163-168.
22.	Legriel S, Mourvillier B, Bele N, et al. Outcomes in 140 critically ill patients with status epilepticus. Intensive Care Medicine, 2008, 34(3): 476-480.
23.	Rossetti A O, Hurwitz S, Logroscino G, et al. Prognosis of status epilepticus: role of aetiology, age, and consciousness impairment at presentation. Journal of Neurology Neurosurgery & Psychiatry, 2006, 77(5): 611-,65.
24.	Koubeissi M, Alshekhlee A. In-hospital mortality ofgeneralized convulsive status epilepticus: a large US sample. Neurology, 2007, 69(9): 886-893.
25.	Tiamkao S, Pranboon S, Thepsuthammarat K, et al. Incidences and outcomes of status epilepticus: A 9-year longitudinal national study. Epilepsy & Behavior, 2015, 49: 135-137.
26.	Sutter R, Tschudinsutter S, Grize L, et al. Associations between infections and clinical outcome parameters in status epilepticus: a retrospective 5-year cohort study. Epilepsia, 2012, 53(9): 1489-1497.
27.	何军. 癫痫持续状态严重程度评分量表在癫痫持续状态预后判断中的作用与价值. 临床合理用药杂志, 2014, (12): 106-110.

1. Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticu-s Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia, 2015, 56(10): 1515-1523.
2. De Lorenzo RJ, Pellock JM, Towne AR, et al. Epidemiology of statusepilepticus. Clin Neurophysiol 1995, 12: 316–325.
3. Wu YW, Shek DW, Garcia PA, et al. Incidence and mortality of generalized convulsive status epilepticus in California. Neurology, 2002, 58: 1070-1076.
4. Knake S, Hamer HM, Rosenow F. Status epilepticus: a critical review. Epilepsy Behav, 2009, 15: 10-14.
5. Rossetti A O, Logroscino G, Milligan T A, et al. Status epilepticus severity score (STESS): a tool to orient early treatment strategy. Journal of Neurology, 2008, 255(10): 1561-1566.
6. 李海峰. 癫痫持续状态63例急诊救治体会. 中国实用神经疾病杂志, 2015, (16): 68-69.
7. Dham BS, Hunter K, Rincon F. The epidemiology of status epilepticus in the united states. Neurocritical Care, 2014, 20(3): 476-483.
8. Vignatelli L, Rinaldi R, Galeotti M, et al. Epidemiology of status epilepticus in a rural area of northern Italy: a 2-year population-based study. Eur J Neurol, 2005, 12(11): 897-902.
9. Logroscino G, Hesdorffer DC, Cascino G, et al. Status epilepticus without an underlying cause and risk of death: a population-based study . Arch Neurol. 2008, 65（2）: 221-224.
10. 宿英英, 黄旭升, 潘速跃, 等. 惊厥性癫癎持续状态监护与治疗(成人)中国专家共识. 中国现代神经疾病杂志, 2015, 25(11): 25-31.
11. Hussain N, Appleton R, Thorburn K. Aetiology, course and outcome of children admitted to paediatric intensive care with convulsive status epilepticus: a retrospective 5-year review. Seizure, 2007, 16(4): 305.
12. Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. NeurocritCare, 2012, 17: 3-23.
13. Mayer SA, Claassen J, Lokin J, et al. Refractory status epilepticus: frequency, risk factors, and impact on outcome. Archives of Neurology, 2002, 59(2): 205-210.
14. Walker MC. Status epilepticus in the intensive care unit. Neurol, 2003, 250: 401-406.
15. 冯鸽. 86例癫痫持续状态的临床分析. 吉林大学, 硕士学位论文, 2011.
16. Wu HM, Huang CC, Chen SH, et al. Herpes simplex virustype 1 inoculation enhances hippocampal excitability andseizure susceptibility in mice. Eur J Neurosci, 2003, 18(12): 3294-3304.
17. Tsakiri N, Kimber I, Rothwell NJ, et al. Mechanisms of interleukin-6 synthesis and release induced by interleukin-1and cell depolarization in neurones. Mol Cell Neurosci, 2008, 37(1): 110-118.
18. Sugai K. Treatment of convulsive status epilepticus in infants and young children in Japan. Acta Neurol Scand, 2007, 115(4): 62-70.
19. Betjemann JP, Lowenstein DH. Status epilepticus in adults. Lancet Neurology, 2015, 14(6): 615-624.
20. Shneker BF, Fountain NB. Assessment of acute morbidity and mortality innonconvulsive status epilepticus. Neurology, 2003, 61: 1066-1073.
21. Hocker S, Wijdicks EF, Rabinstein AA. Refractory status epilepticus: new insights inpresentation, treatment, and outcome. Neurol Res, 2013, 35: 163-168.
22. Legriel S, Mourvillier B, Bele N, et al. Outcomes in 140 critically ill patients with status epilepticus. Intensive Care Medicine, 2008, 34(3): 476-480.
23. Rossetti A O, Hurwitz S, Logroscino G, et al. Prognosis of status epilepticus: role of aetiology, age, and consciousness impairment at presentation. Journal of Neurology Neurosurgery & Psychiatry, 2006, 77(5): 611-,65.
24. Koubeissi M, Alshekhlee A. In-hospital mortality ofgeneralized convulsive status epilepticus: a large US sample. Neurology, 2007, 69(9): 886-893.
25. Tiamkao S, Pranboon S, Thepsuthammarat K, et al. Incidences and outcomes of status epilepticus: A 9-year longitudinal national study. Epilepsy & Behavior, 2015, 49: 135-137.
26. Sutter R, Tschudinsutter S, Grize L, et al. Associations between infections and clinical outcome parameters in status epilepticus: a retrospective 5-year cohort study. Epilepsia, 2012, 53(9): 1489-1497.
27. 何军. 癫痫持续状态严重程度评分量表在癫痫持续状态预后判断中的作用与价值. 临床合理用药杂志, 2014, (12): 106-110.

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