Prognostic factors for status epilepticus

Older age and marked impairment of consciousness at presentation are predictive of death in patients with status epilepticus (SE), according to the results of a recent study.The US study was conducted to identify which characteristics at presentation predict mortality in patients with status epilepticus. The authors explained that a better understanding of such prognostic factors may help select which patients would be most likely to benefit from aggressive treatment, and thus lower the risk of potential over- or under-treatment.The authors studied 96 patients presenting with a first SE episode and 11 patients presenting with recurrent SE. Ten patients initially presenting with a first episode went on to experience recurrent SE during the study period. The authors report that mortality was higher among patients with a first SE episode than among patients with recurrent SE (15.6% versus 4.8%); additionally, a return to baseline clinical conditions was more frequent in the patients with recurrent SE than incident SE (p=0.02).When analysing the results of the cohort with incident SE episodes, the authors found that all but one of the deaths occurred in patients who were stuporous or comatose at presentation. However, SE duration of one hour or more before treatment was equally prevalent in patients who had survived and patients who had died. Multiple logistic analyses found that death was associated with potentially fatal aetiology, age over 65 years, and stupor or coma at presentation. It was not associated with gender, history of epilepsy, SE type, or time to treatment over an hour....