Status epilepticus in scrub typhus versus tuberculous meningitis: A comparative study.

Area of Science:

• Neurology
• Infectious Diseases
• Critical Care Medicine

Background:

• Scrub typhus (ST) and tuberculous meningitis (TBM) are common tropical infections with neurological complications like status epilepticus (SE).
• Comparing SE in TBM and ST is crucial for understanding disease-specific management and outcomes.

Purpose of the Study:

• To compare demographic, clinical, treatment, and outcome differences in status epilepticus (SE) between tuberculous meningitis (TBM) and scrub typhus (ST).

Main Methods:

• Retrospective analysis of patients with TBM-SE and ST-SE from prospective registries.
• Comparison of demographic data, clinical presentation, laboratory findings, EEG, MRI, treatment response, and outcomes.

Main Results:

• TBM-SE patients exhibited distinct laboratory findings (lower hemoglobin, platelets; higher creatinine, bilirubin, ALT) and delayed onset compared to ST-SE.
• TBM-SE showed higher rates of refractory/super-refractory seizures, increased mortality (47.1%), and poorer functional recovery (33% good recovery at 6 months).
• ST-SE patients had normal MRI, early onset, full recovery, and no recurrence after antiseizure medication withdrawal.

Conclusions:

• Status epilepticus in TBM is more refractory, with significantly higher mortality and disability compared to ST.
• Early antiseizure medication withdrawal is feasible in ST-SE, while TBM-SE necessitates prolonged treatment due to its severity and refractory nature.