Mesraoua Boulenouar, Deleu Dirk, Al Hail Hassan, Ibrahim Faisal, Melikyan Gayane, Al Hussein Hassan, Singh Rajvir, Uthman Basim, Streletz Leopold, Kaplan Peter W, Wieser Heinz Gregor
Hamad Medical CorporationDohaQatar.
Weill Cornell Medical CollegeDohaQatar.
J Drug Assess. 2017 Nov 10;6(1):18-32. doi: 10.1080/21556660.2017.1396992. eCollection 2017.
This study reports the prevalence of Nonconvulsive Status Epilepticus (NCSE) in patients with altered mental status (AMS), and describes the clinical presentation, etiology, neurophysiological findings, neuroimaging, treatment, and outcome of NCSE in Qatar. Recording duration of continuous EEG monitoring was also discussed. This was a 3-year, prospective, hospital-based study involving patients with AMS and continuous EEG monitoring admitted to the Emergency and ICUs of Hamad Hospital, Qatar. Patients with confirmed diagnosis of NCSE were compared to the patients who did not show EEG and clinical features compatible with NCSE. Descriptive statistics in terms of mean with standard deviation, as well as frequency and percentages for categorical variables, were calculated; Student's test as well as Chi-square tests or Fisher's exact tests were applied. Logistic regressions NSCE was performed using significance level 0.05 for independent variables at univariate analysis. Number of patients with AMS and continuous EEG monitoring was 250. Number of patients with EEG compatible with NCSE: 65 (age range, 12-79 ys; m, 37; f, 28). Number of controls (defined as patients with EEG not compatible with NCSE): 185 (age range, 12-80 ys; m, 101; f, 84). Rate of occurrence of NCSE in patients with AMS: 26%. NCSE group was younger than controls ( < .001). Twenty patients with NCSE (31%) and 35 patients in the control group (19%) died. Death was more frequent in compared to controls ( < .0007). NCSE proper and comatose NCSE had longer hospital stays than controls ( < .02 and < .03, respectively). Complete recovery occurred in 26 NCSE patients (40%) and in 98 controls (53%) ( < .08). Twenty-one patients (31%) presented with : 12 patients survived, 9 died. This was the first prospective study reporting a high number of NCSE in Qatar, a small country in the MENA region. This prevalence (26%) was in the middle range. NCSE patients did not perform better than controls, outcome being worse with comatose NCSE. NCSE is an emergent condition warranting expedited diagnosis and management. Three days of continuous EEG monitoring were able to diagnose most cases of NCSE.
本研究报告了精神状态改变（AMS）患者中非惊厥性癫痫持续状态（NCSE）的患病率，并描述了卡塔尔NCSE的临床表现、病因、神经生理学检查结果、神经影像学表现、治疗及预后。还讨论了连续脑电图监测的记录时长。这是一项为期3年的前瞻性、基于医院的研究，纳入了卡塔尔哈马德医院急诊科和重症监护病房收治的伴有AMS且接受连续脑电图监测的患者。将确诊为NCSE的患者与未表现出与NCSE相符的脑电图和临床特征的患者进行比较。计算了均值及标准差的描述性统计量，以及分类变量的频率和百分比；应用了Student's检验以及卡方检验或Fisher精确检验。在单因素分析中，对自变量使用显著性水平0.05进行非惊厥性癫痫持续状态的逻辑回归分析。接受AMS评估及连续脑电图监测的患者有250例。脑电图与NCSE相符的患者有65例（年龄范围12 - 79岁；男性37例，女性28例）。对照组（定义为脑电图与NCSE不相符的患者）有185例（年龄范围12 - 80岁；男性101例，女性84例）。AMS患者中NCSE的发生率为26%。NCSE组比对照组年轻（P < 0.001）。20例NCSE患者（31%）和35例对照组患者（19%）死亡。与对照组相比，NCSE患者死亡更常见（P < 0.0007）。典型NCSE和昏迷型NCSE的住院时间比对照组更长（分别为P < 0.02和P < 0.03）。26例NCSE患者（40%）和98例对照组患者（53%）实现了完全康复（P < 0.08）。21例患者（31%）出现……：12例存活患者，9例死亡。这是在中东和北非地区的小国卡塔尔进行的第一项前瞻性研究，报告了大量的NCSE病例。该患病率（26%）处于中等范围。NCSE患者的预后并不优于对照组，昏迷型NCSE的预后更差。NCSE是一种需要快速诊断和治疗的急症。连续3天的脑电图监测能够诊断大多数NCSE病例。
