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[Generalized convulsive status epilepticus: analysis apropos of 57 cases]
E Miñambres García1, X Antolínez Eizaguirre, J Infante Ceberio
1Departamento de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Avenida Valdecilla, s/n. 39008 Santander.
Background:
The generalized convulsive status epilepticus (GCSE) is a medical emergency with a high morbimortality rate. We analyzed the casuistry in our hospital and we assessed the causes related to mortality.
Patients And Methods:
This is a retrospective study of 57 cases of GCSE that took place between january 1992 to december 1998. The variables studied were mortality among groups according to age, previous epilepsy and the duration of the convulsive episode.
Results:
We found male prevalence (63.2%). The 49.2% of patients didn't have previous history of epilepsy. In 38.6% of cases the treatment dose was insufficient and in 61.4% it was delated. The mortality rate was 36.8% with a higher significance in patients older than 65 (p < 0.02), without previous history of epilepsy (p < 0.001) and in episodes lasting more than 4 hours (p < 0.05). Only 12.9% of patients received prehospital treatment.
Conclusions:
The mortality of GCSE is very high. The initial treatment is inadequate. We must establish a premature and adequate protocol, with optim pharmacological doses and a good coordination with intensive care units.