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The importance of timing in epilepsia partialis continua
Ÿ Gutiérrez-Viedma1, M Romeral-Jiménez2, I Serrano-García3
1Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España.
Introduction:
Timing is one of the most important modifiable prognostic factors in the management of status epilepticus. Epilepsia partialis continua (EPC) is a status epilepticus subtype of highly variable, occasionally prolonged, duration. The aim of this study was to analyze the relationship between EPC duration and outcomes.
Methods:
We performed an observational prospective study of all patients with EPC admitted to our tertiary hospital between 1 September 2017 and 1 September 2018.
Results:
The sample included 10 patients, of whom 9 were women; median age was 74 years. The most frequent aetiology was cerebrovascular disease (n=6). EPC onset occurred outside the hospital in 5 patients, with a median time to hospital admission of 4hours. The median time to treatment onset for all patients was 12.3hours. The median time from treatment onset to EPC control was 30hours; time from treatment onset to EPC control showed a strong positive correlation with TT (Spearman's rho=0.88). Six patients presented hyperglycaemia at onset; this was positively correlated with time from treatment onset to EPC control (rho=0.71). All 6 patients with hyperglycaemia presented a brain injury explaining the EPC episode.
Conclusions:
Delays were observed in different phases of EPC management, which was related to longer duration of the episode. Glycaemia was also related to episode duration, probably acting as a triggering factor rather than as the aetiology.
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