Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcome
While new-onset status epilepticus (NOSE) is a harbinger of chronic epilepsy, prospective medical data are sparse in terms of specifying whether the evolution of status epilepticus (SE) and seizure expression in NOSE resembles what occurs in patients who have already been diagnosed with epilepsy [no...
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1101370/full |
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| author | Marie Benaiteau Marie Benaiteau Luc Valton Luc Valton Ludovic Gardy Marie Denuelle Marie Denuelle Rachel Debs Valentin Wucher Valentin Wucher Florence Rulquin Emmanuel J. Barbeau Emmanuel J. Barbeau Fabrice Bonneville Fabrice Bonneville Fabrice Bonneville Jérémie Pariente Jérémie Pariente Jérémie Pariente Jonathan Curot Jonathan Curot Jonathan Curot |
| author_facet | Marie Benaiteau Marie Benaiteau Luc Valton Luc Valton Ludovic Gardy Marie Denuelle Marie Denuelle Rachel Debs Valentin Wucher Valentin Wucher Florence Rulquin Emmanuel J. Barbeau Emmanuel J. Barbeau Fabrice Bonneville Fabrice Bonneville Fabrice Bonneville Jérémie Pariente Jérémie Pariente Jérémie Pariente Jonathan Curot Jonathan Curot Jonathan Curot |
| author_sort | Marie Benaiteau |
| collection | DOAJ |
| description | While new-onset status epilepticus (NOSE) is a harbinger of chronic epilepsy, prospective medical data are sparse in terms of specifying whether the evolution of status epilepticus (SE) and seizure expression in NOSE resembles what occurs in patients who have already been diagnosed with epilepsy [non-inaugural SE (NISE)] in all aspects apart from its inaugural nature. The aim of this study was to compare the clinical, MRI, and EEG features that could distinguish NOSE from NISE. We conducted a prospective monocentric study in which all patients ≥18 years admitted for SE over a 6-month period were included. A total of 109 patients (63 NISE and 46 NOSE cases) were included. Despite similar modified Rankin scores before SE, several aspects of the clinical history distinguished NOSE from NISE patients. NOSE patients were older and frequently had neurological comorbidity and preexisting cognitive decline, but they had a similar prevalence of alcohol consumption to NISE patients. NOSE and NISE evolve in the same proportions as refractory SE (62.5% NOSE, 61% NISE) and share common features such as the same incidence (33% NOSE, 42% NISE, and p = 0.53) and volumes of peri-ictal abnormalities on MRI. However, in NOSE patients, we observed greater non-convulsive semiology (21.7% NOSE, 6% NISE, and p = 0.02), more periodic lateral discharges on EEG (p = 0.004), later diagnosis, and higher severity according to the STESS and EMSE scales (p < 0.0001). Mortality occurred in 32.6% of NOSE patients and 21% of NISE patients at 1 year (p = 0.19), but with different causes of death occurring at different time points: more early deaths directly linked to SE at 1 month occurred in the NOSE group, while there were more remote deaths linked to causal brain lesions in the NISE group at final follow-up. In survivors, 43.6% of the NOSE cases developed into epilepsy. Despite acute causal brain lesions, the novelty related to its inaugural nature is still too often associated with a delay in diagnosing SE and a poorer outcome, which justifies the need to more clearly specify the various types of SE to constantly raise awareness among clinicians. These results highlight the relevance of including novelty-related criteria, clinical history, and temporality of occurrence in the nosology of SE. |
| first_indexed | 2024-04-10T15:31:00Z |
| format | Article |
| id | doaj.art-2e76a4c7414b457dad54dd04aede70cc |
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| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T15:31:00Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-2e76a4c7414b457dad54dd04aede70cc2023-02-13T15:37:08ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-02-011410.3389/fneur.2023.11013701101370Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcomeMarie Benaiteau0Marie Benaiteau1Luc Valton2Luc Valton3Ludovic Gardy4Marie Denuelle5Marie Denuelle6Rachel Debs7Valentin Wucher8Valentin Wucher9Florence Rulquin10Emmanuel J. Barbeau11Emmanuel J. Barbeau12Fabrice Bonneville13Fabrice Bonneville14Fabrice Bonneville15Jérémie Pariente16Jérémie Pariente17Jérémie Pariente18Jonathan Curot19Jonathan Curot20Jonathan Curot21French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, University Hospital of Lyon HCL, Lyon, FranceNeurology Department, Toulouse University Hospital, Toulouse, FranceNeurology Department, Toulouse University Hospital, Toulouse, FranceBrain and Cognition Research Center (CerCo), French National Scientific Research Center, UMR5549, Toulouse, FranceBrain and Cognition Research Center (CerCo), French National Scientific Research Center, UMR5549, Toulouse, FranceNeurology Department, Toulouse University Hospital, Toulouse, FranceBrain and Cognition Research Center (CerCo), French National Scientific Research Center, UMR5549, Toulouse, FranceNeurology Department, Toulouse University Hospital, Toulouse, FranceFrench Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, University Hospital of Lyon HCL, Lyon, FranceSynaptopathies and Autoantibodies (SynatAc) Team, NeuroMyoGene-MeLis Institute, INSERM U1314/CNRS UMR 5284, University of Lyon, Lyon, FranceNeurology Department, Toulouse University Hospital, Toulouse, FranceBrain and Cognition Research Center (CerCo), French National Scientific Research Center, UMR5549, Toulouse, FranceFaculty of Health, University of Toulouse-Paul Sabatier, Toulouse, FranceFaculty of Health, University of Toulouse-Paul Sabatier, Toulouse, FranceINSERM, U1214, Toulouse Neuro Imaging Center (ToNIC), Toulouse, FranceNeuroradiology Department, Toulouse University Hospital, Toulouse, FranceNeurology Department, Toulouse University Hospital, Toulouse, FranceFaculty of Health, University of Toulouse-Paul Sabatier, Toulouse, FranceINSERM, U1214, Toulouse Neuro Imaging Center (ToNIC), Toulouse, FranceNeurology Department, Toulouse University Hospital, Toulouse, FranceBrain and Cognition Research Center (CerCo), French National Scientific Research Center, UMR5549, Toulouse, FranceFaculty of Health, University of Toulouse-Paul Sabatier, Toulouse, FranceWhile new-onset status epilepticus (NOSE) is a harbinger of chronic epilepsy, prospective medical data are sparse in terms of specifying whether the evolution of status epilepticus (SE) and seizure expression in NOSE resembles what occurs in patients who have already been diagnosed with epilepsy [non-inaugural SE (NISE)] in all aspects apart from its inaugural nature. The aim of this study was to compare the clinical, MRI, and EEG features that could distinguish NOSE from NISE. We conducted a prospective monocentric study in which all patients ≥18 years admitted for SE over a 6-month period were included. A total of 109 patients (63 NISE and 46 NOSE cases) were included. Despite similar modified Rankin scores before SE, several aspects of the clinical history distinguished NOSE from NISE patients. NOSE patients were older and frequently had neurological comorbidity and preexisting cognitive decline, but they had a similar prevalence of alcohol consumption to NISE patients. NOSE and NISE evolve in the same proportions as refractory SE (62.5% NOSE, 61% NISE) and share common features such as the same incidence (33% NOSE, 42% NISE, and p = 0.53) and volumes of peri-ictal abnormalities on MRI. However, in NOSE patients, we observed greater non-convulsive semiology (21.7% NOSE, 6% NISE, and p = 0.02), more periodic lateral discharges on EEG (p = 0.004), later diagnosis, and higher severity according to the STESS and EMSE scales (p < 0.0001). Mortality occurred in 32.6% of NOSE patients and 21% of NISE patients at 1 year (p = 0.19), but with different causes of death occurring at different time points: more early deaths directly linked to SE at 1 month occurred in the NOSE group, while there were more remote deaths linked to causal brain lesions in the NISE group at final follow-up. In survivors, 43.6% of the NOSE cases developed into epilepsy. Despite acute causal brain lesions, the novelty related to its inaugural nature is still too often associated with a delay in diagnosing SE and a poorer outcome, which justifies the need to more clearly specify the various types of SE to constantly raise awareness among clinicians. These results highlight the relevance of including novelty-related criteria, clinical history, and temporality of occurrence in the nosology of SE.https://www.frontiersin.org/articles/10.3389/fneur.2023.1101370/fullstatus epilepticusnew-onset status epilepticusnew-onset refractory status epilepticus (NORSE)peri-ictal MRI abnormalitiesoutcomeepilepsy |
| spellingShingle | Marie Benaiteau Marie Benaiteau Luc Valton Luc Valton Ludovic Gardy Marie Denuelle Marie Denuelle Rachel Debs Valentin Wucher Valentin Wucher Florence Rulquin Emmanuel J. Barbeau Emmanuel J. Barbeau Fabrice Bonneville Fabrice Bonneville Fabrice Bonneville Jérémie Pariente Jérémie Pariente Jérémie Pariente Jonathan Curot Jonathan Curot Jonathan Curot Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcome Frontiers in Neurology status epilepticus new-onset status epilepticus new-onset refractory status epilepticus (NORSE) peri-ictal MRI abnormalities outcome epilepsy |
| title | Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcome |
| title_full | Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcome |
| title_fullStr | Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcome |
| title_full_unstemmed | Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcome |
| title_short | Specific profiles of new-onset vs. non-inaugural status epilepticus: From diagnosis to 1-year outcome |
| title_sort | specific profiles of new onset vs non inaugural status epilepticus from diagnosis to 1 year outcome |
| topic | status epilepticus new-onset status epilepticus new-onset refractory status epilepticus (NORSE) peri-ictal MRI abnormalities outcome epilepsy |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1101370/full |
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