[Etiology and clinical signs as short-term risk factors of status epilepticus]

The aim of the study was an analysis of causes, clinical symptoms, complications and predictors of an unfavorable course of status epilepticus (SE).

Retrospective evaluation of medical files of 28 patients (17 M, 11 F, aged 52 +/- 15 yrs) was made. Patients were treated for status epilepticus in a Neurology Clinic in Zabrze between January 1997 and March 2008.

Chronic epilepsy existed in 64% pts, for 10 yrs on an average, in 10% pts SE was a subsequent one. Chronic alcoholism was defined as a most frequent cause of SE, followed by cerebrovascular disorders and brain tumor (32, 14 and 14%, resp.); in 25% pts the cause was not specified. Generalized seizures predominated (82%), in 90% they lasted longer than 60 minutes. In 43% pts biochemical inflammatory indicators on admission were found, more than 20% had fever, in 10% pneumonia was diagnosed. 1/3 of individuals suffered from respirocirculatory insufficiency and in more than 21% new neurological deficits appeared. In treatment, following benzodiazepines, intravenous phenytoin (50%) was used. 35% pts was subjected to pharmacological coma, predominantly by means of thiopental and propofol (25 and 7%, resp.). Mechanical ventilation was necessary in 40% pts. Mortality rate was 32%, with 33% of deaths on the 1st day and 78% before the 7th day.

Chronic alcoholism and older age predominate among causes of death in patient with SE.