Vychopen Martin, Lampmann Tim, Asoglu Harun, Güresir Agi, Vatter Hartmut, Wach Johannes, Güresir Erdem
Department of Neurosurgery, University Hospital Leipzig, 04103 Leipzig, Germany.
Department of Neurosurgery, University Hospital Bonnl, 53127 Bonn, Germany.
Brain Sci. 2023 Jan 22;13(2):184. doi: 10.3390/brainsci13020184.
A non-convulsive status epilepticus (ncSE) is a potentially fatal complication for patients in neurointensive care. In patients with aneurysmal subarachnoid hemorrhage (SAH), ncSE remains scarcely investigated. In this study, we aim to investigate the frequency and influence of non-convulsive status epilepticus on outcome in patients with SAH. We retrospectively analyzed data of consecutive patients with aneurysmal subarachnoid hemorrhage and evaluated clinical, radiological, demographical and electroencephalogram (EEG) data. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months and stratified into favorable (mRS 0-2) vs. unfavorable (mRS 3-6). We identified 171 patients with SAH, who received EEG between 01/2012 and 12/2020. ncSE was diagnosed in 19 patients (3.7%), only one of whom achieved favorable outcome. The multivariate regression analysis revealed four independent predictors of unfavorable outcome: presence of ncSE ( = 0.003; OR 24.1; 95 CI% 2.9-195.3), poor-grade SAH ( < 0.001; OR 14.0; 95 CI% 8.5-23.1), age ( < 0.001; OR 2.8; 95 CI% 1.6-4.6) and the presence of DIND ( < 0.003; OR 1.9; 95 CI% 1.2-3.1) as independent predictors for unfavorable outcome. According to our study, development of ncSE in patients suffering SAH might correlate with poor prognosis. Even when medical treatment is successful and no EEG abnormalities are detected, the long-term outcome remains poor.
非惊厥性癫痫持续状态（ncSE）是神经重症监护患者潜在的致命并发症。在动脉瘤性蛛网膜下腔出血（SAH）患者中，ncSE的研究仍然很少。在本研究中，我们旨在调查非惊厥性癫痫持续状态的发生率及其对SAH患者预后的影响。我们回顾性分析了连续性动脉瘤性蛛网膜下腔出血患者的数据，并评估了临床、放射学、人口统计学和脑电图（EEG）数据。根据改良Rankin量表（mRS）在6个月时评估预后，并分为良好（mRS 0-2）和不良（mRS 3-6）。我们确定了171例在2012年1月至2020年12月期间接受脑电图检查的SAH患者。19例（3.7%）被诊断为ncSE，其中只有1例预后良好。多因素回归分析显示了四个不良预后的独立预测因素：ncSE的存在（ = 0.003；OR 24.1；95%CI 2.9-195.3）、低级别SAH（ < 0.001；OR 14.0；95%CI 8.5-23.1）、年龄（ < 0.001；OR 2.8；95%CI 1.6-4.6）和弥漫性脑损伤（DIND）的存在（ < 0.003；OR 1.9；95%CI 1.2-3.1）作为不良预后的独立预测因素。根据我们的研究，SAH患者发生ncSE可能与预后不良相关。即使药物治疗成功且未检测到脑电图异常，长期预后仍然很差。
