Analysis of clinical characteristics and risk factors for mortality in human status epilepticus

Purpose: To analyse clinical data including aetiology, age, antecedents, classification and mortality in human status epilepticus (SE), and to assess prognostic factors for mortality. Methods: A prospective study was performed, including detailed analysis of clinical and laboratorial data of SE in individuals of any age. except neonates. Results: One hundred and eleven SE were included, with patients' age ranging from 3 months to 98 years. SE incidence peaked in the first year of life, and 59.4% of the individuals had previous epilepsy while 40.6% had not. The main underlying causes were noncompliance to treatment in the first group, and CNS infection, stroke and metabolic disturbances in the second group. Overall mortality was 19.8%. and deaths were correlated to aetiology and patient's age. Refractory SE affected 11.7% of the cases. Clinical types included focal, secondarily generalised and generalised SE. Clinical and clinicoelectrographic classifications were convergent, but EEG was essential for the diagnosis in 4.5% of the cases. Conclusions: Epileptic patients are at greater risk to develop SE, however, individuals with no prior history of epilepsy and acute neurological problems can also present SE. Aetiology varies with patient's age, and mortality is high and related to age and underlying causes. Clinical and clinicoelectrographic classifications are usually convergent, but in some cases the diagnosis of SE would not be established without the EEG. (C) 2003 BEA Trading Ltd. Published by Elsevier Science Ltd. All rights reserved.