Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice
Introduction: Status epilepticus (SE) is a neurological emergency associated with significant mortality and morbidity. We analyse characteristics of this entity in our population. Methods: Data from electronic medical records of adults diagnosed with SE were collected retrospectively from 5 hospital...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier España
2017-06-01
|
| Series: | Neurología (English Edition) |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2173580817300743 |
| _version_ | 1811260937977462784 |
|---|---|
| author | M.A. de la Morena Vicente J.J. Granizo Martínez J. Ojeda Ruiz de Luna A. Peláez Hidalgo M. Luque Alarcón F.J. Navacerrada Barrero S. Al Hussayni Husseini E. García Cobos L. Ballesteros Plaza G. de las Casas Cámara I. Viudez Jiménez |
| author_facet | M.A. de la Morena Vicente J.J. Granizo Martínez J. Ojeda Ruiz de Luna A. Peláez Hidalgo M. Luque Alarcón F.J. Navacerrada Barrero S. Al Hussayni Husseini E. García Cobos L. Ballesteros Plaza G. de las Casas Cámara I. Viudez Jiménez |
| author_sort | M.A. de la Morena Vicente |
| collection | DOAJ |
| description | Introduction: Status epilepticus (SE) is a neurological emergency associated with significant mortality and morbidity. We analyse characteristics of this entity in our population. Methods: Data from electronic medical records of adults diagnosed with SE were collected retrospectively from 5 hospitals over 4 years. Results: Data reflected 84 episodes of SE in 77 patients with a mean age of 60.3 years. Of this sample, 52.4% had a previous history of epilepsy. Status classification: 47.6% tonic–clonic, 21.4% complex partial, 17.9% partial motor, 6% partial simple, 3.6% myoclonic, and 3.6% subtle SE. Based on the duration of the episode, SE was defined in this study as early stage (up to 30 min) in 13.1%, established (30-120 min) in 20.2%, refractory (more than 120 min) in 41.7%, and super-refractory (episodes continuing or recurring after more than 24 h of anaesthesia) in 13.1%. Ten patients (11.9%) died when treatment failed to control SE. The cumulative percentage of success achieved was 8.3% with the first treatment, 27.3% for the second, 48.7% for the third, 58.2% for the fourth, 70.1% for the fifth, 80.8% for the sixth, 83.2% for the seventh, and 84.4% for the eighth. Conclusions: In our study, we found that SE did not respond to treatment within 2 hours in approximately half the cases and 11.9% of the patients died without achieving seizure control, regardless of the type of status. Half the patients responded by the third treatment but some patients needed as many as 8 treatments to resolve seizures. Using large registers permitting analysis of the different types and stages of SE is warranted. Resumen: Introducción: El estatus epiléptico es una urgencia neurológica asociada a una mortalidad y morbilidad significativa. Analizamos las características en nuestra población. Métodos: Se recogieron los datos de manera retrospectiva de la historia clínica electrónica de adultos con diagnóstico de estatus epiléptico en 5 centros hospitalarios durante 4 años. Resultados: Se obtuvieron datos de un total de 84 episodios en 77 pacientes, con edad media de 60,3 años. El 52,4% tenían historia previa de epilepsia. Clasificación según el tipo de estatus: 47,6% tónico-clónico; 21,4% parcial complejo; 17,9% parcial motor; 6% parcial simple; 3,6% mioclónico y 3,6% sutil. Si analizamos el momento que finalizó el estatus según las fases definidas para este estudio obtenemos: 13,1% precoz (hasta 30 min); 20,2% establecido (entre 30-120 min); 41,7% refractario (más de 120 min) y 13,1% superrefractario (continúan o recurren después de más de 24 h de anestesia). Diez casos (11,9%) fallecieron sin haberse controlado el estatus. El porcentaje acumulativo de éxito alcanzado con el primer tratamiento fue de 8,3%; segundo 27,3%; tercero 48,7%; cuarto 58,2%; quinto 70,1%; sexto 80,8%; séptimo 83,2% y octavo 84,4%. Conclusiones: En nuestro estudio encontramos que el estatus no se controló en las primeras 2 h en casi la mitad de los casos, y un 11,9% fallecieron sin controlarse, sin haber diferencias significativas entre el tipo de estatus. En casi la mitad se logró el control del estatus con el tercer tratamiento, pero en algún caso se precisó hasta 8. Son necesarios registros amplios que permitan analizar el manejo en los distintos tipos y fases. Keywords: Status epilepticus, Treatment, Prognosis, Tonic–clonic, Complex partial, Partial motor, Palabras clave: Estatus epileptico, Tratamiento, Pronóstico, Tónico-clonico, Parcial complejo, Parcial motor |
| first_indexed | 2024-04-12T18:55:02Z |
| format | Article |
| id | doaj.art-bd2c3c26a2774c7e825fd9381b4699b9 |
| institution | Directory Open Access Journal |
| issn | 2173-5808 |
| language | English |
| last_indexed | 2024-04-12T18:55:02Z |
| publishDate | 2017-06-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Neurología (English Edition) |
| spelling | doaj.art-bd2c3c26a2774c7e825fd9381b4699b92022-12-22T03:20:21ZengElsevier EspañaNeurología (English Edition)2173-58082017-06-01325284289Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practiceM.A. de la Morena Vicente0J.J. Granizo Martínez1J. Ojeda Ruiz de Luna2A. Peláez Hidalgo3M. Luque Alarcón4F.J. Navacerrada Barrero5S. Al Hussayni Husseini6E. García Cobos7L. Ballesteros Plaza8G. de las Casas Cámara9I. Viudez Jiménez10Hospital Universitario Infanta Cristina, Parla, Madrid, Spain; Corresponding author.Hospital Universitario Infanta Cristina, Parla, Madrid, SpainHospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, SpainHospital Universitario del Henares, Coslada, Madrid, SpainHospital Universitario del Tajo, Aranjuez, Madrid, SpainHospital Universitario del Sureste, Arganda del Rey, Madrid, SpainHarrogate District Hospital, United KingdomHospital Universitario del Henares, Coslada, Madrid, SpainHospital Universitario Infanta Cristina, Parla, Madrid, SpainHospital Universitario Infanta Elena, Valdemoro, Madrid, SpainHospital Universitario Infanta Cristina, Parla, Madrid, SpainIntroduction: Status epilepticus (SE) is a neurological emergency associated with significant mortality and morbidity. We analyse characteristics of this entity in our population. Methods: Data from electronic medical records of adults diagnosed with SE were collected retrospectively from 5 hospitals over 4 years. Results: Data reflected 84 episodes of SE in 77 patients with a mean age of 60.3 years. Of this sample, 52.4% had a previous history of epilepsy. Status classification: 47.6% tonic–clonic, 21.4% complex partial, 17.9% partial motor, 6% partial simple, 3.6% myoclonic, and 3.6% subtle SE. Based on the duration of the episode, SE was defined in this study as early stage (up to 30 min) in 13.1%, established (30-120 min) in 20.2%, refractory (more than 120 min) in 41.7%, and super-refractory (episodes continuing or recurring after more than 24 h of anaesthesia) in 13.1%. Ten patients (11.9%) died when treatment failed to control SE. The cumulative percentage of success achieved was 8.3% with the first treatment, 27.3% for the second, 48.7% for the third, 58.2% for the fourth, 70.1% for the fifth, 80.8% for the sixth, 83.2% for the seventh, and 84.4% for the eighth. Conclusions: In our study, we found that SE did not respond to treatment within 2 hours in approximately half the cases and 11.9% of the patients died without achieving seizure control, regardless of the type of status. Half the patients responded by the third treatment but some patients needed as many as 8 treatments to resolve seizures. Using large registers permitting analysis of the different types and stages of SE is warranted. Resumen: Introducción: El estatus epiléptico es una urgencia neurológica asociada a una mortalidad y morbilidad significativa. Analizamos las características en nuestra población. Métodos: Se recogieron los datos de manera retrospectiva de la historia clínica electrónica de adultos con diagnóstico de estatus epiléptico en 5 centros hospitalarios durante 4 años. Resultados: Se obtuvieron datos de un total de 84 episodios en 77 pacientes, con edad media de 60,3 años. El 52,4% tenían historia previa de epilepsia. Clasificación según el tipo de estatus: 47,6% tónico-clónico; 21,4% parcial complejo; 17,9% parcial motor; 6% parcial simple; 3,6% mioclónico y 3,6% sutil. Si analizamos el momento que finalizó el estatus según las fases definidas para este estudio obtenemos: 13,1% precoz (hasta 30 min); 20,2% establecido (entre 30-120 min); 41,7% refractario (más de 120 min) y 13,1% superrefractario (continúan o recurren después de más de 24 h de anestesia). Diez casos (11,9%) fallecieron sin haberse controlado el estatus. El porcentaje acumulativo de éxito alcanzado con el primer tratamiento fue de 8,3%; segundo 27,3%; tercero 48,7%; cuarto 58,2%; quinto 70,1%; sexto 80,8%; séptimo 83,2% y octavo 84,4%. Conclusiones: En nuestro estudio encontramos que el estatus no se controló en las primeras 2 h en casi la mitad de los casos, y un 11,9% fallecieron sin controlarse, sin haber diferencias significativas entre el tipo de estatus. En casi la mitad se logró el control del estatus con el tercer tratamiento, pero en algún caso se precisó hasta 8. Son necesarios registros amplios que permitan analizar el manejo en los distintos tipos y fases. Keywords: Status epilepticus, Treatment, Prognosis, Tonic–clonic, Complex partial, Partial motor, Palabras clave: Estatus epileptico, Tratamiento, Pronóstico, Tónico-clonico, Parcial complejo, Parcial motorhttp://www.sciencedirect.com/science/article/pii/S2173580817300743 |
| spellingShingle | M.A. de la Morena Vicente J.J. Granizo Martínez J. Ojeda Ruiz de Luna A. Peláez Hidalgo M. Luque Alarcón F.J. Navacerrada Barrero S. Al Hussayni Husseini E. García Cobos L. Ballesteros Plaza G. de las Casas Cámara I. Viudez Jiménez Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice Neurología (English Edition) |
| title | Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice |
| title_full | Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice |
| title_fullStr | Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice |
| title_full_unstemmed | Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice |
| title_short | Retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice |
| title_sort | retrospective multicentre observational study on clinical management and treatment of different types of status epilepticus in clinical practice |
| url | http://www.sciencedirect.com/science/article/pii/S2173580817300743 |
| work_keys_str_mv | AT madelamorenavicente retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT jjgranizomartinez retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT jojedaruizdeluna retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT apelaezhidalgo retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT mluquealarcon retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT fjnavacerradabarrero retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT salhussaynihusseini retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT egarciacobos retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT lballesterosplaza retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT gdelascasascamara retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice AT iviudezjimenez retrospectivemulticentreobservationalstudyonclinicalmanagementandtreatmentofdifferenttypesofstatusepilepticusinclinicalpractice |