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Relationship between Status Epilepticus Severity Score and etiology in adult NCSE patients.
Ideggyogy Sz 2019; 72(7-8):257-263IS

Abstract

Background and purpose

Nonconvulsive status epilepticus (NCSE) is a heterogeneous, severe neurological disorder of different etiologies. In this study, the outcomes of NCSE episodes was assessed in a large series of adult patients. Our objective was to evaluate relationship between Status Epilepticus Severity Score (STESS) and etiology and the role of etiological factors on predicting the outcomes.

Methods

In this retrospective study, the medical records of 95 patients over 18 years of age who were diagnosed with NCSE between June 2011 and December 2015 were reviewed. Their treatment and follow-up for NCSE was performed at the Epilepsy Unit in Department of Neurology, Antalya Research and Training Hospital. Etiological factors thought to be responsible for NCSE episodes as well as the prognostic data were retrieved. The etiological factors were classified into three groups as those with a known history of epilepsy (Group 1), primary neurological disorder (Group 2), or systemic/unknown etiology (Group 3). STESS was retrospectively applied to patients.

Results

There were 95 participants, 59 of whom were female. Group 1, Group 2, and Group 3 consisted of 11 (7 female), 54 (33 female), and 30 (19 female) patients, respectively. Of the 18 total deaths, 12 occurred in Group 2, and 6 in Group 3. The negative predictive value for a STESS score of ≤ 2 was 93.88% (+LR 2.05 95% CI: 1.44-2.9 and -LR 0.3 95% CI 0.10-0.84) in the overall study group. While the corresponding values for Group 1 (patients with epilepsy), Group 2 (patients with primary neurological disorder), and group 3 (patients with systemic or unknown etiology) were 100%, 92.59% (+LR 2.06 95%CI: 1.32-3.21 and -LR 0.28 95% CI 0.08-1.02) 83.33% (+LR 1.14 95%CI: 0.59-2.9 and -LR 0.80 95% CI 0.23-2.73).

Conclusion

This study included the one of the largest patients series ever reported in whom STESS, a clinical scoring system proposed for use in patients with status epilepticus, has been implemented. Although STESS appeared to be quite useful for predicting a favorable outcome in NCSE patients with epilepsy and primary neurological disorders, its predictive value in patients with systemic or unknown etiology was lower. Further prospective studies including larger NCSE samples are warranted.

Authors+Show Affiliations

Antalya Training and Research Hospital, Department of Neurology Antalya, Turkey.Antalya Training and Research Hospital, Department of Neurology Antalya, Turkey.Antalya Training and Research Hospital, Department of Neurology Antalya, Turkey.Antalya Training and Research Hospital, Department of Neurology Antalya, Turkey.Antalya Training and Research Hospital, Department of Neurology Antalya, Turkey.Muğla Sıtkı Koçman University Faculty of Medicine Department of Neurology and Clinical Neurophysiology, Muğla, Turkey.Antalya Training and Research Hospital, Department of Neurology Antalya, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31517458

Citation

Genç, Fatma, et al. "Relationship Between Status Epilepticus Severity Score and Etiology in Adult NCSE Patients." Ideggyogyaszati Szemle, vol. 72, no. 7-8, 2019, pp. 257-263.
Genç F, Erdal A, Akça G, et al. Relationship between Status Epilepticus Severity Score and etiology in adult NCSE patients. Ideggyogy Sz. 2019;72(7-8):257-263.
Genç, F., Erdal, A., Akça, G., Karaçay, E., Göksu, E. Ö., Kutlu, G., & Gömceli, Y. B. (2019). Relationship between Status Epilepticus Severity Score and etiology in adult NCSE patients. Ideggyogyaszati Szemle, 72(7-8), pp. 257-263. doi:10.18071/isz.72.0257.
Genç F, et al. Relationship Between Status Epilepticus Severity Score and Etiology in Adult NCSE Patients. Ideggyogy Sz. 2019 Jul 30;72(7-8):257-263. PubMed PMID: 31517458.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between Status Epilepticus Severity Score and etiology in adult NCSE patients. AU - Genç,Fatma, AU - Erdal,Abidin, AU - Akça,Gizem, AU - Karaçay,Ertan, AU - Göksu,Eylem Özaydın, AU - Kutlu,Gülnihal, AU - Gömceli,Yasemin Biçer, PY - 2019/9/14/entrez PY - 2019/9/14/pubmed PY - 2019/10/2/medline KW - epilepsy KW - etiology KW - nonconvulsive status epilepticus KW - status epilepticus severity score SP - 257 EP - 263 JF - Ideggyogyaszati szemle JO - Ideggyogy Sz VL - 72 IS - 7-8 N2 - Background and purpose: Nonconvulsive status epilepticus (NCSE) is a heterogeneous, severe neurological disorder of different etiologies. In this study, the outcomes of NCSE episodes was assessed in a large series of adult patients. Our objective was to evaluate relationship between Status Epilepticus Severity Score (STESS) and etiology and the role of etiological factors on predicting the outcomes. Methods: In this retrospective study, the medical records of 95 patients over 18 years of age who were diagnosed with NCSE between June 2011 and December 2015 were reviewed. Their treatment and follow-up for NCSE was performed at the Epilepsy Unit in Department of Neurology, Antalya Research and Training Hospital. Etiological factors thought to be responsible for NCSE episodes as well as the prognostic data were retrieved. The etiological factors were classified into three groups as those with a known history of epilepsy (Group 1), primary neurological disorder (Group 2), or systemic/unknown etiology (Group 3). STESS was retrospectively applied to patients. Results: There were 95 participants, 59 of whom were female. Group 1, Group 2, and Group 3 consisted of 11 (7 female), 54 (33 female), and 30 (19 female) patients, respectively. Of the 18 total deaths, 12 occurred in Group 2, and 6 in Group 3. The negative predictive value for a STESS score of ≤ 2 was 93.88% (+LR 2.05 95% CI: 1.44-2.9 and -LR 0.3 95% CI 0.10-0.84) in the overall study group. While the corresponding values for Group 1 (patients with epilepsy), Group 2 (patients with primary neurological disorder), and group 3 (patients with systemic or unknown etiology) were 100%, 92.59% (+LR 2.06 95%CI: 1.32-3.21 and -LR 0.28 95% CI 0.08-1.02) 83.33% (+LR 1.14 95%CI: 0.59-2.9 and -LR 0.80 95% CI 0.23-2.73). Conclusion: This study included the one of the largest patients series ever reported in whom STESS, a clinical scoring system proposed for use in patients with status epilepticus, has been implemented. Although STESS appeared to be quite useful for predicting a favorable outcome in NCSE patients with epilepsy and primary neurological disorders, its predictive value in patients with systemic or unknown etiology was lower. Further prospective studies including larger NCSE samples are warranted. SN - 0019-1442 UR - https://www.unboundmedicine.com/medline/citation/31517458/Relationship_between_Status_Epilepticus_Severity_Score_and_etiology_in_adult_NCSE_patients DB - PRIME DP - Unbound Medicine ER -