Besides being one of the most common neurological urgencies, status epilepticus (SE) correlates with high rates of morbidity and mortality, in particular in cases of SE resistant to first and second-lines therapies. In these patients, however, the factors influencing prognosis and the treatment strategies are still debated. We consecutively recruited patients admitted for refractory or super-refractory status epilepticus (RSE or SRSE) to the Neurological and Intensive Care Units of Bellaria Hospital and Maggiore Hospital of Bologna over 10-month period in ordere to clarify etiological, neurophysiological and therapeutic factors which can influence prognosis. We collected 7 RSE and 3 SRSE cases (one convulsive SE, 1 non-convulsive status epilepticus in Coma - NSEC- and 8 focal SE). Two patients had STRSS scores < or egual to 2, 8 > or egual to 3. Mortality rate was 30% at one month. CONCLUSIONS: Therapeutic approaches have been extremely variable in our small population, mostly because of different etiologies, comorbidities and doctor's attitudes. This study, though limited to a small population, suggests the need to define common guidelines and therapeutical procedures since the status onset in order to avoid the risk to "induce" refractory SE.
Multidisciplinary approach to refractory status epileptics in adulthood: state of the art in Bologna and suggestions for improvement.
Pasini, Elena
;Zanello, Marco
;
2016
Abstract
Besides being one of the most common neurological urgencies, status epilepticus (SE) correlates with high rates of morbidity and mortality, in particular in cases of SE resistant to first and second-lines therapies. In these patients, however, the factors influencing prognosis and the treatment strategies are still debated. We consecutively recruited patients admitted for refractory or super-refractory status epilepticus (RSE or SRSE) to the Neurological and Intensive Care Units of Bellaria Hospital and Maggiore Hospital of Bologna over 10-month period in ordere to clarify etiological, neurophysiological and therapeutic factors which can influence prognosis. We collected 7 RSE and 3 SRSE cases (one convulsive SE, 1 non-convulsive status epilepticus in Coma - NSEC- and 8 focal SE). Two patients had STRSS scores < or egual to 2, 8 > or egual to 3. Mortality rate was 30% at one month. CONCLUSIONS: Therapeutic approaches have been extremely variable in our small population, mostly because of different etiologies, comorbidities and doctor's attitudes. This study, though limited to a small population, suggests the need to define common guidelines and therapeutical procedures since the status onset in order to avoid the risk to "induce" refractory SE.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
