Kohli Sahil, Pasangulapati Suresh Babu, Yoganathan Sangeetha, Rynjah Gideon Lyngsyun, Prabhakar A T, Aaron Sanjith, Alexander Mathew, Mathew Vivek
Department of Neurosciences, Christian Medical College, Vellore, Tamil Nadu, India.
Ann Indian Acad Neurol. 2017 Apr-Jun;20(2):116-121. doi: 10.4103/aian.AIAN_385_16.
To determine the proportion of refractory status epilepticus (RSE) and super-RSE (SRSE) among patients with status epilepticus (SE) and to analyze RSE and non-RSE (NRSE) in terms of etiology and predictors for RSE.
Patients were identified from discharge summaries database with keywords of SE and records of the portable electroencephalogram (EEG) machine from January 2011 to March 2016.
Two hundred and eighteen events were included in the study with 114 (52.3%) males, bimodal age preponderance age <5 years 30%, and second peak in age 15-65 years 52.8%, preexisting seizures were present in 34.4% ( = 75). Nearly 77.1% had NRSE ( = 168) and 22.9% had RSE ( = 50). This included 17 patients with SRSE ( = 17, 7.8% of all SE). Central nervous system (CNS) infection was a single largest etiological group in SE (69/218, 31.7%). In RSE, autoimmune encephalitis (17/50) and CNS infection (13/50) were the largest groups. seizures ( = 0.007), low sensorium at admission ( = 0.001), low albumin at admission ( = 0.002), and first EEG being abnormal ( = 0.001) were risk factors on bivariate analysis. An unfavorable status epilepticus severity score (STESS) was predictive for RSE ( = 0.001). On multivariate analysis, seizures ( = 0.009) and abnormal EEG at admission ( = 0.03) were predictive for RSE.
Fifty patients had RSE (22.9%), of which 17 went on to become SRSE (7.8%). Unfavorable STESS score was predictive for RSE on bivariate analysis. On multivariate analysis, seizures and abnormal initial EEG were predictors of RSE.
确定癫痫持续状态（SE）患者中难治性癫痫持续状态（RSE）和超难治性癫痫持续状态（SRSE）的比例，并从病因及RSE的预测因素方面分析RSE和非RSE（NRSE）。
从2011年1月至2016年3月出院小结数据库中通过SE关键词及便携式脑电图（EEG）机记录来识别患者。
本研究纳入218例事件，其中男性114例（52.3%），年龄呈双峰分布，年龄<5岁者占30%，15 - 65岁者占52.8%，既往有癫痫发作史者占34.4%（n = 75）。近77.1%为NRSE（n = 168），22.9%为RSE（n = 50）。其中包括17例SRSE患者（n = 17，占所有SE的7.8%）。中枢神经系统（CNS）感染是SE中最大的单一病因组（69/218，31.7%）。在RSE中，自身免疫性脑炎（17/50）和CNS感染（13/50）是最大的组。惊厥（P = 0.007）、入院时意识不清（P = 0.001）、入院时白蛋白水平低（P = 0.002）以及首次脑电图异常（P = 0.001）在二元分析中是危险因素。癫痫持续状态严重程度评分（STESS）不良对RSE具有预测性（P = 0.001）。在多变量分析中，惊厥（P = 0.009）和入院时脑电图异常（P = 0.03）对RSE具有预测性。
50例患者为RSE（22.9%），其中17例发展为SRSE（7.8%）。在二元分析中，STESS评分不良对RSE具有预测性。在多变量分析中，惊厥和初始脑电图异常是RSE的预测因素。
