Oxidative stress in status epilepticus: A clinical-radiological correlation

To report oxidative stress in the patients with status epilepticus (SE), and correlate these with severity, MRI and outcome.

Thirty-five patients with SE and 34 controls were included. Blood sample was collected at admission for measuring superoxide dismutase (SOD), catalase, protein carbonyl, glutathione, total antioxidant capacity (TAC), malondialdehyde (MDA) and nitric oxide (NO). The type of SE, duration and Status Epilepticus Severity Score (STESS) at admission and refractoriness to treatment were noted. Cranial magnetic resonance imaging (MRI) findings, in-hospital deaths and disability at discharge were noted.

The median age of the patients was 35 and 14 were females. The median STESS was 3 (0-5), and the score was unfavorable in 21(60%) patients. MRI was abnormal in 27(77%) patients. The patients with SE had significantly lower concentrations of SOD, catalase, protein carbonyl, GSH and TAC and higher concentrations of MDA and NO compared to the controls. These levels did not differ between refractory and non-refractory SE. Glutathione level inversely correlated with age. Malondialdehyde and NO levels positively correlated with age and inversely with GSH level. Five (14.3%) patients died in hospital. At discharge, 14 patients had good and 16 had poor outcome. The oxidative stress markers did not correlate with death or disability.

Oxidative stress is increased in the patients with SE. Further study is needed in larger sample size to explore probable adjunctive treatment option.