Clinical characteristics of status epilepticus in an emergency hospital: imortance of nonconvulsive status epilepticus

Yoshimura, H.; Takano, S.; Kawamoto, M.; Beppu, M.; Ohara, N.; Kobayashi, J.; Kuzuya, A.; Yamagami, H.; Kohara, N.

Rinsho Shinkeigaku 48(4): 242-248

2008


ISSN/ISBN: 0009-918X
DOI: 10.5692/clinicalneurol.48.242
Accession: 068510572

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Abstract
Although nonconvulsive status epilepticus (NCSE) is a major neurological emergency, its frequency and clinical course are not well clarified. We investigated the clinical characteristics of status epilepticus focusing on the significance of NCSE. One thousand seven hundred twenty-three patients were admitted as neurological emergency cases in our hospital between October 2003 and September 2006. Of these cases, 94 (5.5%) were diagnosed as status epilepticus of which, 24 (25.5%) were diagnosed with NCSE on admission. Moreover, 8 patients who presented with convulsive status epilepticus on admission had episodes of NCSE during hospitalization. Thus, 32 patients (34.0%) suffered from NCSE during their clinical course. We analyzed the prognostic factors of status epilepticus using the Glasgow Outcome Scale. Poor outcome was significantly correlated with NCSE (p = 0.003) and acute cerebrovascular disease (p = 0.010), independent of age, sex, history of epilepsy, and other etiologies. Our study revealed that NCSE is not a rare condition and results in a poor outcome. Careful EEG evaluation of patients with consciousness disturbance might increase the diagnostic accuracy of NCSE, and aggressive treatment of patients with NCSE should be necessary to improve the prognosis of NCSE.