Nilo Annacarmen, Pauletto Giada, Lorenzut Simone, Merlino Giovanni, Verriello Lorenzo, Janes Francesco, Bax Francesco, Gigli Gian Luigi, Valente Mariarosaria
Clinical Neurology Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy.
Neurology Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy.
J Clin Med. 2023 Jan 18;12(3):769. doi: 10.3390/jcm12030769.
(1) Background: Stroke is one of the most frequent causes of status epilepticus (SE) in adults. Patients with stroke and SE have poorer prognosis than those with stroke alone. We described characteristics and prognosis of early- and late-onset post-stroke SE (PSSE). (2) Methods: We retrospectively analyzed consecutive stroke patients who experienced a first SE between August 2012 and April 2021, comparing clinical characteristics, stroke, and SE features between early- versus late-onset SE in relation to patients' outcome. (3) Results: Forty stroke patients experienced PSSE. Fourteen developed an early-onset SE (35%) and twenty-six a late-onset SE (65%). Early-onset SE patients had a slightly higher NIHSS score at admission (6.9 vs. 6.0; = 0.05). Early-onset SE was more severe than late-onset, according to STESS (Status Epilepticus Severity Score) (3.5 vs. 2.8; = 0.05) and EMSE (Epidemiology-based Mortality score in Status Epilepticus) score (97.0 vs. 69.5; = 0.04); furthermore, it had a significant impact on disability at 3-month and 1-year follow-up ( = 0.03 and = 0.02). SE recurrence and seizures relapse were observed mainly in cases of late-onset SE. (4) Conclusions: Early-onset SE seems to be associated with higher disability in short- and long-term follow-up as possible expression of severe acute brain damage.
(1) 背景：中风是成人癫痫持续状态（SE）最常见的病因之一。中风合并SE的患者预后比单纯中风患者更差。我们描述了中风后早发性和迟发性癫痫持续状态（PSSE）的特征及预后。(2) 方法：我们回顾性分析了2012年8月至2021年4月期间首次发生SE的连续性中风患者，比较早发性和迟发性SE患者的临床特征、中风及SE特点与患者预后的关系。(3) 结果：40例中风患者发生了PSSE。14例发生早发性SE（35%），26例发生迟发性SE（65%）。早发性SE患者入院时NIHSS评分略高（6.9对6.0；P = 0.05）。根据癫痫持续状态严重程度评分（STESS）（3.5对2.8；P = 0.05）和癫痫持续状态基于流行病学的死亡率评分（EMSE）（97.0对69.5；P = 0.04），早发性SE比迟发性更严重；此外，在3个月和1年随访时，早发性SE对残疾有显著影响（P = 0.03和P = 0.02）。SE复发和癫痫发作复发主要见于迟发性SE病例。(4) 结论：早发性SE在短期和长期随访中似乎与更高的残疾率相关，这可能是严重急性脑损伤的一种表现。
