Prognostic indicators of non-convulsive status epilepticus in intensive care unit

Acta Neurol Belg. 2023 Aug;123(4):1257-1266. doi: 10.1007/s13760-022-01981-6. Epub 2022 Jun 3.

Abstract

Background: To determine the rate of non-convulsive status epilepticus with/without prominent motor phenomena (SE-PM/ NCSE) and predictive value of electroclinical findings of continious electroencephalography (cEEG) monitoring of these patients and its association with prognosis in intensive care units (ICU).

Methods: We retrospectively collected data of 218 patients whose cEEG was performed in ICU between 2016 and 2018. The cEEG for NCSE diagnosis was evaluated according to Salzburg Consensus Criteria (SCC).

Results: The mean age of patients was 57.09 ± 18.9 (16-95) years and 49.1% (107) were female. Of 218 patients, 32 (14.7%) had SE-PM/NCSE. According to SCC the rate of NCSE (NCSE + possible NCSE) was 9.6% (n = 21). Prior to cEEG recording, 38.9% (n = 85) of overall patients had a history of seizure/convulsion, and 22.7% (n = 21) of these patients diagnosed with NCSE based on cEEG. The mortality rates in critically ill patients were 41.3% (30.8%, 42.8%; for SE-PM and NCSE respectively). Prognosis was associated with age, epilepsy diagnosis, having convulsion/seizure history on follow-up, GCS, need for ventilation, kind of drugs, sepsis diagnosis, and minimum frequency of background activity of the cEEG (p = 0.001, 0.002, 0.001, 0.020, 0.001, 0.001, 0.001, 0.0001 respectively).

Conclusions: NCSE findings are mostly found in patients who were comatose and had seizure/convulsion history on follow-up. Mortality is higher in patients diagnosed with NCSE followed in the ICU compared to SE-PM.

Keywords: Hypnosedative drugs; Intensive care unit; Non-convulsive status epilepticus NCSE; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Electroencephalography
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Seizures
  • Status Epilepticus* / diagnosis