Prognosis after Status Epilepticus

Abstract

OBJECTIVE: To determine the clinical characteristics and prognostic factors of status epilepticus (SE) in Hong Kong. BACKGROUND: SE is a neurological emergency with significant mortality and morbidity. There is currently limited data regarding the causes and outcomes of SE in our locality. DESIGN/METHODS: We retrospectively studied the clinical characteristics, clinical outcome of adults diagnosed with convulsive SE and managed at a regional hospital in Hong Kong during January 1st 2007 – December 31st 2011. RESULTS: A total of 38 patients with convulsive SE were identified during the study period. The mean age was 58 years (range 21-92 years) and 61% were males. Underlying cerebrovascular disease (34%), poor compliance to anti-convulsants in patients with known epilepsy (16%) and infection of the central nervous system (11%) were the main causes of convulsive SE. SE was associated with 21% mortality during hospitalization period and 32% mortality within 6-months of admission. Age 65 years, prior history of seizures, a higher blood glucose level during SE and a Status Epilepticus Severity Score (STESS) 4 were associated with 6-month mortality (p<0.05). Multi-variate analysis subsequently identified a STESS 4 as an independent predictor of poor prognosis (p=0.03). CONCLUSIONS: Convulsive SE in adults is most commonly due to underlying cerebrovascular disease and is associated with a high mortality. The STESS is a useful tool in predicting 6-month mortality.