Salzburg Criteria, A Useful Tool in Non-Convulsive Status Epilepticus Diagnosis: A Retrospective Study

2021 ◽  
pp. 155005942199171
Author(s):  
Adriana Gómez Domínguez ◽  
Raidili C. Mateo Montero ◽  
Alba Díaz Cid ◽  
Antonio J. P. Mazarro ◽  
Ignacio R. Bailly-Bailliere ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Status Epilepticus ◽  
Prospective Studies ◽  
Correct Diagnosis ◽  
Original Description ◽  
Neurological Deficits ◽  
Convulsive Status Epilepticus ◽  
Poor Outcome

Introduction. Non-convulsive status epilepticus (NCSE) has been traditionally a challenging electroencephalographic (EEG) diagnosis. For this reason, Salzburg consensus criteria (SCC) have been proposed to facilitate correct diagnosis. Methods. We retrospectively reanalyzed 41 cases referred to our department (from 2016 to 2018) under the suspicion of NCSE. In this study, we compared the original description (standard criteria) versus the updated description (SCC) of the same EEG. Results. Originally, 15 patients were diagnosed as NCSE (37%) and 26 patients as no NCSE (63%), using the standard criteria. Then, we analyzed EEGs according to the SCC, which led to the following results: 9 patients fulfilled the criteria for definite NCSE (22%), 20 patients were diagnosed as possible NCSE (49%) and 12 patients were diagnosed as no NCSE (29%). Subsequently, when we analyze the outcome of possible NCSE cases, we note that 50% of these patients presented mild-poor outcome (neurological deficits, deceased). Indeed, we observed worse outcomes in patients previously diagnosed as no NCSE and untreated, specifically post-anoxic cases. Conclusions. Salzburg criteria seem to be a useful tool to support NCSE diagnosis, introducing the category of possible NCSE. In our study, we observed that it contributes to improving the prognosis and management of the patients. However, more prospective studies are needed to demonstrate the accuracy of SCC.

scholarly journals Predictive Factors for Refractory Convulsive Status Epilepticus: a 7-year Retrospective Study

2015 ◽  
Vol 49 (1) ◽  
Author(s):  
Marc Laurence L. Fernandez ◽  
Leah L. Shiong Shu ◽  
Natasha L. Fabiana ◽  
Paul Matthew D. Pasco ◽  
Leonor I. Cabral-Lim ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Status Epilepticus ◽  
Predictive Factors ◽  
Convulsive Status Epilepticus

...

scholarly journals Non-convulsive status epilepticus causing focal neurological deficits in CADASIL

2007 ◽  
Vol 78 (11) ◽  
pp. 1287-1289 ◽  
Author(s):  
P. O Valko ◽  
M. M Siccoli ◽  
A. Schiller ◽  
H.-G. Wieser ◽  
H. H Jung
Keyword(s):  
Status Epilepticus ◽  
Neurological Deficits ◽  
Convulsive Status Epilepticus

scholarly journals Retrospective analysis underestimates neurological deficits in complex spinal deformity surgery: a Scoli-RISK-1 Study

2017 ◽  
Vol 27 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Michael P. Kelly ◽  
Lawrence G. Lenke ◽  
Jakub Godzik ◽  
Ferran Pellise ◽  
Christopher I. Shaffrey ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Cohort Studies ◽  
Prospective Study ◽  
Spinal Deformity ◽  
Neurological Deficit ◽  
Prospective Studies ◽  
Adult Spinal Deformity ◽  
Statistical Significance ◽  
Neurological Deficits ◽  
Inclusion Criteria

OBJECTIVEThe authors conducted a study to compare neurological deficit rates associated with complex adult spinal deformity (ASD) surgery when recorded in retrospective and prospective studies. Retrospective studies may underreport neurological deficits due to selection, detection, and recall biases. Prospective studies are expensive and more difficult to perform, but they likely provide more accurate estimates of new neurological deficit rates.METHODSNew neurological deficits were recorded in a prospective study of complex ASD surgeries (pSR1) with a defined outcomes measure (decrement in American Spinal Injury Association lower-extremity motor score) for neurological deficits. Using identical inclusion criteria and a subset of participating surgeons, a retrospective study was created (rSR1) and neurological deficit rates were collected. Continuous variables were compared with the Student t-test, with correction for multiple comparisons. Neurological deficit rates were compared using the Mantel-Haenszel method for standardized risks. Statistical significance for the primary outcome measure was p < 0.05.RESULTSOverall, 272 patients were enrolled in pSR1 and 207 patients were enrolled in rSR1. Inclusion criteria, defining complex spinal deformities, and exclusion criteria were identical. Sagittal Cobb measurements were higher in pSR1, although sagittal alignment was similar. Preoperative neurological deficit rates were similar in the groups. Three-column osteotomies were more common in pSR1, particularly vertebral column resection. New neurological deficits were more common in pSR1 (pSR1 17.3% [95% CI 12.6–22.2] and rSR1 9.0% [95% CI 5.0–13.0]; p = 0.01). The majority of deficits in both studies were at the nerve root level, and the distribution of level of injury was similar.CONCLUSIONSNew neurological deficit rates were nearly twice as high in the prospective study than the retrospective study with identical inclusion criteria. These findings validate concerns regarding retrospective cohort studies and confirm the need for and value of carefully designed prospective, observational cohort studies in ASD.

scholarly journals Non-convulsive status epilepticus causing focal neurological deficits in CADASIL

2009 ◽  
Vol 2009 (jan21 1) ◽  
pp. bcr0720080529-bcr0720080529 ◽  
Author(s):  
P. O Valko ◽  
M. M Siccoli ◽  
A. Schiller ◽  
H. G Wieser ◽  
H. H Jung
Keyword(s):  
Status Epilepticus ◽  
Neurological Deficits ◽  
Convulsive Status Epilepticus

scholarly journals Non-convulsive status epilepticus causing focal neurological deficits in CADASIL

2009 ◽  
Vol 2009 (jan27 1) ◽  
pp. bcr0820080713-bcr0820080713 ◽  
Author(s):  
P. O Valko ◽  
M. M Siccoli ◽  
A. Schiller ◽  
H. G Wieser ◽  
H. H Jung
Keyword(s):  
Status Epilepticus ◽  
Neurological Deficits ◽  
Convulsive Status Epilepticus

scholarly journals Exposure to parasitic infections determines features and phenotypes of active convulsive epilepsy in Africa

2021 ◽  
Vol 6 ◽  
pp. 200
Author(s):  
Nelson K. Langat ◽  
Symon M. Kariuki ◽  
Gathoni Kamuyu ◽  
Angelina Kakooza-Mwesige ◽  
Seth Owusu-Agyei ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Neurological Deficits ◽  
Parasitic Infections ◽  
Convulsive Status Epilepticus ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Case Comparison ◽  
The Central Nervous System

Background: Epilepsy affects 70 million people worldwide, 80% of whom are in low-and-middle income countries (LMICs). Infections of the central nervous system (CNS) contribute considerably to the burden of epilepsy in LMICs, but the nature and presentation of epilepsy following these infections is not fully understood. We examined if epilepsy foutcomes are associated with the exposure to parasitic infections. Methods: This was a case-comparison study nested in a cross-sectional survey of people with active convulsive epilepsy, with cases as those exposed to parasitic infections, and comparison as those unexposed. Associations of exposure to parasites with clinical and electroencephalographic features of epilepsy were done using a modified mixed effects Poisson regression model across five sites in Africa. Multiplicative and additive scale (RERI) interactions were explored to determine the effect of co-infections on epilepsy features. Population attributable fractions (PAF) were calculated to determine the proportion of severe clinical and electroencephalographic features of epilepsy attributable to CNS infections. Results: A total of 997 participants with active convulsive epilepsy from the five African sites were analyzed, 51% of whom were males. Exposure to parasitic infections was associated with more frequent seizures in adult epilepsy (relative risk (RR)=2.58, 95% confidence interval (95%CI):1.71-3.89). In children, exposure to any parasite was associated with convulsive status epilepticus (RR=4.68, (95%CI: 3.79-5.78), intellectual disabilities (RR=2.13, 95%CI: 1.35-3.34) and neurological deficits (RR=1.92, 95%CI: 1.42-2.61). Toxoplasma gondii and Onchocerca volvulus interacted synergistically to increase the risk of status epilepticus (RERI=0.91, 95%CI=0.48-1.35) in the data pooled across the sites. Exposure to parasitic infections contributed to 30% of severe features of epilepsy as shown by PAF. Conclusions: Parasitic infections may determine features and phenotypes of epilepsy through synergistic or antagonistic interactions, which can be different in children and adults.  Interventions to control or manage infections may reduce complications and improve prognosis in epilepsy.

Diagnostic accuracy of the Salzburg EEG criteria for non-convulsive status epilepticus: a retrospective study

2016 ◽  
Vol 15 (10) ◽  
pp. 1054-1062 ◽  
Author(s):  
Markus Leitinger ◽  
Eugen Trinka ◽  
Elena Gardella ◽  
Alexandra Rohracher ◽  
Gudrun Kalss ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Status Epilepticus ◽  
Diagnostic Accuracy ◽  
Convulsive Status Epilepticus

scholarly journals Long-Term Survival and Outcome in Children Admitted to Kilifi District Hospital with Convulsive Status Epilepticus

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Agnes Prins ◽  
Eddie Chengo ◽  
Victor Mung'ala Odera ◽  
Manish Sadarangani ◽  
Claire Seaton ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Neurological Deficits ◽  
Control Group ◽  
Convulsive Status Epilepticus ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Neurodevelopmental Impairment ◽  
Active Epilepsy

Objectives. The incidence of convulsive status epilepticus (CSE) is high in Africa but the long-term outcome is unknown. We examined the neurocognitive outcome and survival of children treated for CSE in a Kenyan hospital 3 to 4 years after discharge. Methods. The frequency and nature of neurological deficits among this group of children were determined and compared to a control group. The children were screened with the Ten Questions Questionnaire for neurodevelopmental impairment if alive and those that screened positive were invited for further assessment to determine the pattern and extent of their impairment. A verbal autopsy was performed to determine the cause of death in those that died. Results. In the 119 cases followed-up, 9 (8%) died after discharge, with the majority having seizures during their fatal illness. The 110 survivors (median age 5 years) had significantly more neurological impairments on the screening compared to 282 controls (34/110 (30.9%) versus 11/282 (3.9%), OR = 11.0, 95% CI 5.3–22.8). Fifteen percent of the cases had active epilepsy. Conclusions. This study demonstrates the considerable burden of CSE in African children. Strategies to manage children with CSE that are acceptable to the community need to be explored to improve the longer-term outcome.

scholarly journals Post-Hypoxic Myoclonus Status following Out-of-Hospital Cardiac Arrest—Does It still Predict a Poor Outcome? A Retrospective Study

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 41
Author(s):  
Anne C. Brøchner ◽  
Peter Lindholm ◽  
Margrethe J. Jensen ◽  
Palle Toft ◽  
Finn L. Henriksen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Retrospective Study ◽  
Status Epilepticus ◽  
Treatment Strategies ◽  
Prehospital Treatment ◽  
Poor Outcome ◽  
Improved Outcomes ◽  
One Year ◽  
Hospital Cardiac Arrest

In patients with out-of-hospital cardiac arrest (OHCA), the initial prehospital treatment and transfer of patients directly to intervention clinics—bypassing smaller hospitals—have improved outcomes in recent years. Despite the improved treatment strategies, some patients develop myoclonic status following OHCA, and this phenomenon is usually considered an indicator of poor outcome. With this study, we wanted to challenge this perception. The regional prehospital database in Odense in the Region of Southern Denmark was searched for patients with OHCA from the period of 2011–2016. All 900 patients presenting with a diagnosis of OHCA were included in the study. Patients surviving to the hospital and presenting with myoclonic status were followed for up to one year. Only 2 out of 38 patients with myoclonic status and status epilepticus verified by an EEG survived more than one year. Eleven out of 36 patients with myoclonic status but without status epilepticus survived for more than one year. We found no evidence that myoclonic status is an unmistakable sign of poor outcome when not associated with EEG-verified status epilepticus. The conclusion for clinicians involved in post-resuscitation care is that myoclonic status is uncomfortable to witness but does not necessarily indicate that further treatment is futile.

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