Clinical Characteristics and Risk Factors for Severity and Prognosis of Convulsive Status Epilepticus

Convulsive status epilepticus (CSE) is a frequently encountered serious condition in the field of neurology. Research on CSE has always been a key issue in the field of neurological emergencies. Quickly assessing the severity and prognosis of CSE is crucial for guiding treatment. However, the associated risk factors are not yet fully understood. This study aims to examine the clinical characteristics of CSE patients admitted to our hospital and identify the risk factors that influence the severity of CSE and its prognosis.

We retrospectively collected clinical data from CSE patients admitted to our hospital between July 2023 and December 2024. We grouped patients based on the modified Status Epilepticus Severity Score (mSTESS score) at onset and the Glasgow Outcome Scale score (GOS score) at discharge. This grouping allowed us to assess the severity and prognosis of CSE. We collected clinical characteristics such as age, gender, medical history, etiology, mSTESS score, treatment, comorbidities, duration of seizure, maintenance of antiepileptic drugs at discharge, and GOS score at discharge. The clinical characteristics of CSE patients were analyzed, and related risk factors for severity and prognosis were explored.

A total of 104 patients with CSE were included, consisting of 60 males and 44 females. The average age of patients was 58.05 (±17.50), ranging from 15 to 88 years. Among these patients, generalized convulsive status epilepticus (GCSE) accounted for 76 cases (73.1%), with stroke being the most common cause of CSE, contributing to 45 cases (43.3%). Eight (7.7%) developed into RSE. Severity, defined as mSTESS ≥ 4, was observed in 65 patients (62.5%), while poor outcomes, indicated by GOS ≤ 3, were noted in 40 patients (38.5%). Multivariate logistic analysis demonstrated that the duration of CSE had a statistically significant impact on severity (mSTESS ≥ 4) (95% CI, 1.06-2.47; p < 0.05). Regarding prognosis, the mSTESS score had statistical significance for poor outcomes (GOS ≤ 3) (95% CI, 1.45-4.00, p < 0.05).

Following the occurrence of CSE, the duration of seizures is an independent risk factor for severity, while the mSTESS score has predictive significance for prognosis.