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Hospital-onset seizures: an inpatient study.
Madeline C Fields1, Daniel L Labovitz, Jacqueline A French
1Department of Neurology, Mount Sinai School of Medicine, One Gustave L. Levy Pl, New York, NY 10029, USA. Madeline.fields@mssm.edu
JAMA Neurology
|January 16, 2013
Summary
Hospital-onset seizures (HOS) frequently occur as new-onset events, are often recurrent, and are linked to increased mortality. Management often involves older antiepileptic drugs.
Area of Science:
- Neurology
- Clinical Medicine
- Pharmacology
Background:
- Hospital-onset seizures (HOS) represent a significant clinical challenge.
- Understanding the characteristics and management of HOS is crucial for improving patient outcomes.
Purpose of the Study:
- To characterize demographic and clinical features of patients experiencing HOS.
- To evaluate current management strategies for HOS.
Main Methods:
- Retrospective review of medical records from academic, tertiary care centers.
- Inclusion criteria: patients aged ≥18 years with HOS between January 1 and December 31, 2007.
- Exclusion criteria: patients admitted for epilepsy or seizure evaluation.
Main Results:
- 218 patients with HOS identified; 64% had new-onset seizures.
- Generalized tonic-clonic seizures were most common (33%).
- Metabolic derangements were the most frequent identifiable cause (20%).
- New-onset seizures were associated with higher mortality (19% vs 5%, P = .004).
- Phenytoin was the most common initial antiepileptic drug (61%).
Conclusions:
- HOS frequently present as new-onset seizures and are often recurrent.
- HOS, particularly new-onset cases, are associated with significant mortality.
- Current prescribing practices often favor older antiepileptic drugs for HOS management.
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