Post-Stroke Status Epilepticus: Time of Occurrence May Be the Difference?

Area of Science:

• Neurology
• Stroke Medicine
• Epileptology

Background:

• Stroke is a leading cause of status epilepticus (SE) in adults.
• Patients with stroke and SE face worse prognoses compared to stroke alone.
• Understanding early- vs. late-onset post-stroke SE (PSSE) is crucial for prognosis.

Purpose of the Study:

• To characterize early- and late-onset PSSE.
• To compare clinical features and outcomes of early- vs. late-onset PSSE.
• To evaluate the prognostic impact of SE onset timing post-stroke.

Main Methods:

• Retrospective analysis of 40 stroke patients with first SE (August 2012 - April 2021).
• Comparison of clinical characteristics, stroke, and SE features based on SE onset timing (early vs. late).
• Assessment of patient outcomes, including disability at 3-month and 1-year follow-up.

Main Results:

• 14 (35%) early-onset SE and 26 (65%) late-onset SE cases identified.
• Early-onset SE showed higher NIHSS, STESS, and EMSE scores, indicating greater severity.
• Early-onset SE significantly impacted 3-month and 1-year disability; SE recurrence was mainly in late-onset cases.

Conclusions:

• Early-onset PSSE is associated with increased short- and long-term disability.
• This suggests early-onset SE may reflect severe acute brain damage.
• Timely intervention and management strategies for early-onset PSSE are warranted.