Predictors of functional disability at hospital discharge after status epilepticus

Although status epilepticus is a common neurological emergency, literature about its short term functional disability is scarce and often difficult to interpret. The aim of the present study was to identify possible predictive factors of functional disability in a well-selected cohort of EEG-confirmed status epilepticus patients.

We carried out a retrospective evaluation of clinical and radiologic parameters potentially affecting status epilepticus-related disability in a cohort of adult patients admitted to our institution between 2003 and 2013. Functional decline was defined as a ≥ 1 increase in the modified Rankin scale from preadmission to discharge.

Seventy-nine patients fulfilled inclusion criteria (46% male). Median age was 69 years. History of epilepsy was present in 49% of patients. Deterioration occurred in 46 subjects (58%). Multivariate analysis revealed the following negative predicting factors for disability: normal neuroimaging (OR = 0.031) and presence of status epilepticus on hospital admission (OR = 0.127).

Patients without evident brain lesions are at low risk of functional deterioration development. SE on admission portends a good prognosis as well, probably because it is more promptly treated and it develops in subjects with less systemic complications compared to those in hospital.