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Convulsive status epilepticus: clinical profile in a developing country
Jagarlapudi M K Murthy1, Sita S Jayalaxmi, Meena A Kanikannan
1Department of Neurology, The Institute of Neurological Sciences, CARE Hospital, Hyderabad, India. jmkmurthy@satyam.net.in
Epilepsia
|July 27, 2007
Summary
Longer duration of status epilepticus (SE) and acute causes predict poor response to initial treatment. Treatment failure and SE duration are key factors influencing patient outcomes in developing countries.
Area of Science:
- Neurology
- Public Health
- Clinical Medicine
Background:
- Status epilepticus (SE) care in developing nations faces significant challenges, notably transportation barriers.
- Understanding the clinical profile, treatment response, and outcomes of SE is crucial for improving patient care.
Purpose of the Study:
- To investigate the clinical characteristics, treatment efficacy, and outcomes of status epilepticus (SE) in a developing country context.
- To identify predictors of treatment response and mortality in SE patients.
Main Methods:
- A prospective study of 85 status epilepticus (SE) patients was conducted between 1994 and 1996.
- Data collected included patient demographics, SE duration, etiology, treatment response (first-line and second-line drugs), and Glasgow Outcome Scale (GOS).
Main Results:
- The mean SE duration before admission was 18 hours, with only 28% presenting within 3 hours.
- Acute symptomatic etiology (54%) and CNS infections (28%) were common causes.
- 88% responded to first-line drugs, but longer SE duration and acute symptomatic etiology predicted non-response.
- Mortality was predicted by female sex and lack of response to first-line drugs. Longer SE duration correlated with poor GOS outcomes.
Conclusions:
- Longer SE duration and acute symptomatic etiology independently predict poor response to first-line treatments.
- Treatment failure and SE duration are significant predictors of patient outcomes, highlighting the need for timely intervention.
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