Does semiology of status epilepticus have an impact on treatment response and outcome?
OBJECTIVE
This study investigated whether there is an association between semiology of status epilepticus (SE) and response to treatment and outcome.


METHOD
Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2±17.5 (18-97) years. Patient demographics, SE semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS).


RESULTS
The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS≤3) with an overall mortality of 12.4%. SE was refractory to treatment in 21.5% of the patients. Older age, potentially fatal etiology, systemic infections, NCSE in coma, refractory SE, treatment with anesthetics, long SE duration (>24h), low Glasgow Coma Scale (GCS) (≤8) at onset, and high Status Epilepticus Severity Score (STESS-3) (≥3) were associated with poor short-term outcome and death (p<0.05). Potentially fatal etiology and low GCS were the strongest predictors of poor outcome (Exp [b]: 4.74 and 4.10 respectively, p<0.05).


CONCLUSION
Status epilepticus semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.
['Baysal-Kirac|Leyla|L|', 'Feddersen|Berend|B|', 'Einhellig|Marion|M|', 'Rémi|Jan|J|', 'Noachtar|Soheyl|S|']
D000293:Adolescent D000328:Adult D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D000927:Anticonvulsants D002561:Cerebrovascular Disorders D003128:Coma D004569:Electroencephalography D005260:Female D023261:Glasgow Outcome Scale D006801:Humans D008297:Male D008875:Middle Aged D011446:Prospective Studies D013226:Status Epilepticus D013997:Time Factors D016896:Treatment Outcome D055815:Young Adult
Semiology Status epilepticus Outcome Coma Nonconvulsive status epilepticus STESS