scholarly journals Spectrum and Predictors of Refractory Status Epilepticus in a Developing Country

2017 ◽  
Vol 44 (5) ◽  
pp. 538-546 ◽  
Author(s):  
Deepanshu Dubey ◽  
Sanjeev K. Bhoi ◽  
Jayantee Kalita ◽  
Usha K. Misra
Keyword(s):  
Status Epilepticus ◽  
Developing Country ◽  
Care Center ◽  
Tertiary Care ◽  
Refractory Status Epilepticus ◽  
Cns Infection ◽  
Metabolic Encephalopathy ◽  
Refractory Status ◽  
The Status ◽  
Poor Outcomes

AbstractObjective: Refractory status epilepticus (RSE) can influence the outcome of status epilepticus (SE). In the present study, we report the aetiology and predictors of outcomes of RSE in a developing country. Methods: This is a prospective hospital-based study of SE patients (continuous seizures for five minutes or more). Those who had SE persisting after two antiepileptic drugs were defined as having RSE. We present the demographic information, duration, and type of SE, and we note its severity using the status epilepticus severity score (STESS), its aetiology, comorbidities and imaging findings. The outcome of RSE was defined as cessation of seizures and the condition upon discharge, as assessed by the modified Rankin Scale. Results: A total of 35 (42.5%) of our 81 patients had RSE. The median duration of SE before starting treatment was 2 hours (range=0.008-160 h). The most common causes of RSE were stroke in 5 (14.3%), central nervous system (CNS) infections in 12 (34.3%) and metabolic encephalopathies in 13 (37.1%) patients. Some 21 (60%) patients had comorbidities, and the STESS was favourable in 7 (20%) patients. A total of 14 (20%) patients died, but death was directly related to SE in only one of these. Some 10 patients had super-refractory status epilepticus, which was due to CNS infection in 5 (50%) and metabolic encephalopathy in 3 (30%). On multivariate analysis, an unfavourable STESS (p=0.05) and duration of SE before treatment (p=0.01) predicted RSE. Metabolic aetiology (p=0.05), mechanical ventilation (p<0.001) and age >60 years (p=0.003) were predictors of poor outcomes. Conclusions: RSE was common (42.5%) among patients with SE in a tertiary care center in India. It was associated with high mortality and poor outcomes. Age above 60 years and metabolic aetiology were found to be predictors of poor outcomes.

scholarly journals Management of refractory status epilepticus at a tertiary care centre in a developing country

Seizure ◽  
2010 ◽  
Vol 19 (2) ◽  
pp. 109-111 ◽  
Author(s):  
Manjari Tripathi ◽  
Deepti Vibha ◽  
Navita Choudhary ◽  
Kameshwar Prasad ◽  
M.V. Padma Srivastava ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Developing Country ◽  
Tertiary Care ◽  
Refractory Status Epilepticus ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Refractory Status

scholarly journals Study of refractory status epilepticus from a tertiary care center

2017 ◽  
Vol 20 (2) ◽  
pp. 116 ◽  
Author(s):  
Vivek Mathew ◽  
Sahil Kohli ◽  
SureshBabu Pasangulapati ◽  
Sangeetha Yoganathan ◽  
GideonLyngsyun Rynjah ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Care Center ◽  
Tertiary Care ◽  
Refractory Status Epilepticus ◽  
Tertiary Care Center ◽  
Refractory Status

The efficacy of topiramate in adult refractory status epilepticus: Experience of a Tertiary Care Center

2012 ◽  
Vol 98 (2-3) ◽  
pp. 232-237 ◽  
Author(s):  
Andrea S. Synowiec ◽  
Kristin A. Yandora ◽  
Vamsi Yenugadhati ◽  
James P. Valeriano ◽  
Carol J. Schramke ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Care Center ◽  
Tertiary Care ◽  
Refractory Status Epilepticus ◽  
Tertiary Care Center ◽  
Refractory Status

Determinants and predictors of outcome in super refractory status epilepticus—A developing country perspective

2014 ◽  
Vol 108 (9) ◽  
pp. 1609-1617 ◽  
Author(s):  
Sita Jayalakshmi ◽  
Devashish Ruikar ◽  
SudhindraVooturi ◽  
Suvarna Alladi ◽  
Sambit Sahu ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Developing Country ◽  
Refractory Status Epilepticus ◽  
Predictors Of Outcome ◽  
Refractory Status

Refractory status epilepticus: A developing country perspective

2010 ◽  
Vol 290 (1-2) ◽  
pp. 60-65 ◽  
Author(s):  
S. Sinha ◽  
D.K. Prashantha ◽  
K. Thennarasu ◽  
G.S. Umamaheshwara Rao ◽  
P. Satishchandra
Keyword(s):  
Status Epilepticus ◽  
Developing Country ◽  
Refractory Status Epilepticus ◽  
Refractory Status

scholarly journals Management of super refractory status epilepticus

2020 ◽  
Author(s):  
Dedy Kurniawan ◽  
Abdulloh Machin ◽  
Hanik Badriyah Hidayati ◽  
Wardah Rahmatul Islamiyah
Keyword(s):  
Status Epilepticus ◽  
Continuous Monitoring ◽  
Refractory Status Epilepticus ◽  
Clinical Judgement ◽  
Convulsive Status Epilepticus ◽  
Electrographic Seizure ◽  
Aggressive Therapy ◽  
Refractory Status ◽  
The Status ◽  
Prolonged Recovery

Super refractory status epilepticus ( SRSE ) is the status epilepticus in which the seizures continue for 24 hour or more after anesthetic medications to control and reappear when the patient is weaned from the anesthetic agent. Characteristic seizures are distinguished, by the presence and/or absence of motor seizure, into convulsive and non-convulsive status epilepticus (NCSE). An aggressive therapy is often needed after diagnosis is confirmed. Continuous monitoring during therapy is very important. The management for SRSE includes pharmacological and non-pharmacological treatment. Clinical and electrographic seizure suppression is the treatment goal. After that we need to find and treat the cause of seizures. Clinical judgement by the clinician is needed to identify the risks of excessive suppression of the nervous system, so as the morbidity and mortality is reduced for those patients who can survive but often have difficult and prolonged recovery. Received: 24 Oct 2018Reviewed: 28 Oct 2018Accepted: 6 Nov 2018 Citation: Kurniawan D, Machin A, Hidayati HB, Islamiyah WR. Management of super refractory status epilepticus. Anaesth Pain & Intensiv Care 2018;22 Suppl 1:S67-S72

scholarly journals New-Onset Refractory Status Epilepticus: More Investigations, More Questions

2016 ◽  
Vol 8 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Philippe Dillien ◽  
Susana Ferrao Santos ◽  
Vincent van Pesch ◽  
Vanessa Suin ◽  
Sophie Lamoral ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Immune Therapy ◽  
Healthy Woman ◽  
Refractory Status Epilepticus ◽  
Refractory Status ◽  
The Status ◽  
Third Line Therapy ◽  
High Doses ◽  
Third Line ◽  
New Onset

A 27-year-old previously healthy woman was admitted to the hospital with recurrent seizures. Status epilepticus developed that became refractory to third-line therapy with propofol and barbiturates. The patient had a very extensive diagnostic workup including autoimmune, viral and genetic investigations. A tentative immune therapy was proposed with high doses of steroids and plasma exchanges. Our patient had an inherited heterozygous single nucleotide variant in the sequence c.1280A>G [p.Lys427Arg] of the SMC3 gene that was insufficient to explain the seizures. Surprisingly, IgM antibodies against Japanese encephalitis virus were positive on the serum drawn 11 days after symptom onset, as detected by ELISA and the immunofluorescence antibody (IFA) technique. IgG antibodies were also positive using the IFA technique, but not with ELISA. The same investigations as well as the detection of the viral genome by the q-RT-PCR technique were negative on cerebrospinal fluid. Despite the suspicion of a viral infection, we concluded that our patient had a new-onset refractory status epilepticus of cryptogenic origin. Termination of the status epilepticus was obtained after 47 days, with a possible benefit from the introduction of ketamine.

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