Convulsive Status Epilepticus- A Clinical Radiological and Outcome Study from Uttar Pradesh, India 1174-1177
Correspondence
Dr. Malini Kulshrestha,
Assistant Professor, Department of, Medicine
Rohilkhand Medical College & Hospital,
Bareilly (U.P.)-243006, India.
Phone : 09897112341
E-mail: malinik@gmail.com
Context:
Status Epilepticus (SE) is a neurological emergency which is associated with heterogeneous aetiopathologies, which vary with time and cultural and environmental factors.
Aim:
To analyze the current trends of the clinical profile of SE in our region and to study the predictors of the response of Anti - Epileptic Drugs (AED).
Settings and Design:
A prospective, cross sectional study was done on 50 patients who presented with SE with a duration of 5 minutes or more, at a medical college which is located in the state of Uttar Pradesh, India.
Materials and Methods:
A detailed history was taken and neurological examinations and baseline investigations were done in all the patients. Cerebrospinal Fluid (CSF) analysis was done wherever it was indicated and CT scan / MRI of the brain was carried out in a majority of the patients. The response to the first line of drugs and the outcome were noted and they were correlated with the aetiology and the duration of SE. Results: The mean age of the patients who presented with SE was 29.94±1.76 years and their ages ranged from 12 to 75 years. The duration between the onset of SE and the hospital treatment averaged at 23.56 ± 3.16 hours, ranging from 1hr to 90 hrs. Twenty six percent of the patients were presented within ≤ 6 hrs. The atiology was acute symptomatic in 52% of the cases and the commonest cause was Central Nervous System (CNS) infections. 22% cases of SE were established as epileptic cases with a poor drug compliance. CT/MRI was found to be normal in 44.1 % patients when it was done on 49 patients, wherein ring enhancing lesions were the commonest abnormality which was found. CSF analysis was done in seven patients who presented as meningo-encephalitis. 88% patients had responded to the first line drugs. Two deaths out of 3 corresponded to the acute symptomatic group.
Conclusions:
SE had a variable prognosis depending on its duration and the aetiology of the seizure.