Á Gutiérrez-Viedma1, M Romeral-Jiménez2, I Serrano-García3, B Parejo-Carbonell2, M L Cuadrado-Pérez4, I Sanz-Graciani2, I García-Morales2. 1. Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España. Electronic address: alvgut05@ucm.es. 2. Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España. 3. Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España; Unidad de Metodología de Investigación y Epidemiología Clínica, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España. 4. Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España; Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España.
Abstract
INTRODUCTION: Timing is one of the most important modifiable prognostic factors in the management of status epilepticus. Epilepsia partialis continua (EPC) is a status epilepticus subtype of highly variable, occasionally prolonged, duration. The aim of this study was to analyze the relationship between EPC duration and outcomes. METHODS: We performed an observational prospective study of all patients with EPC admitted to our tertiary hospital between 1 September 2017 and 1 September 2018. RESULTS: The sample included 10 patients, of whom 9 were women; median age was 74 years. The most frequent aetiology was cerebrovascular disease (n=6). EPC onset occurred outside the hospital in 5 patients, with a median time to hospital admission of 4hours. The median time to treatment onset for all patients was 12.3hours. The median time from treatment onset to EPC control was 30hours; time from treatment onset to EPC control showed a strong positive correlation with TT (Spearman's rho=0.88). Six patients presented hyperglycaemia at onset; this was positively correlated with time from treatment onset to EPC control (rho=0.71). All 6 patients with hyperglycaemia presented a brain injury explaining the EPC episode. CONCLUSIONS: Delays were observed in different phases of EPC management, which was related to longer duration of the episode. Glycaemia was also related to episode duration, probably acting as a triggering factor rather than as the aetiology.
INTRODUCTION: Timing is one of the most important modifiable prognostic factors in the management of status epilepticus. Epilepsia partialis continua (EPC) is a status epilepticus subtype of highly variable, occasionally prolonged, duration. The aim of this study was to analyze the relationship between EPC duration and outcomes. METHODS: We performed an observational prospective study of all patients with EPC admitted to our tertiary hospital between 1 September 2017 and 1 September 2018. RESULTS: The sample included 10 patients, of whom 9 were women; median age was 74 years. The most frequent aetiology was cerebrovascular disease (n=6). EPC onset occurred outside the hospital in 5 patients, with a median time to hospital admission of 4hours. The median time to treatment onset for all patients was 12.3hours. The median time from treatment onset to EPC control was 30hours; time from treatment onset to EPC control showed a strong positive correlation with TT (Spearman's rho=0.88). Six patients presented hyperglycaemia at onset; this was positively correlated with time from treatment onset to EPC control (rho=0.71). All 6 patients with hyperglycaemia presented a brain injury explaining the EPC episode. CONCLUSIONS: Delays were observed in different phases of EPC management, which was related to longer duration of the episode. Glycaemia was also related to episode duration, probably acting as a triggering factor rather than as the aetiology.
Authors: Elma M Paredes-Aragón; Héctor E Valdéz-Ruvalcaba; Andrea Santos-Peyret; Marcela Cisneros-Otero; Raúl Medina-Rioja; Sandra Orozco-Suárez; Miriam M Hernandez; Michele D L Breda-Yepes; Verónica Rivas-Alonso; José J Flores-Rivera; Iris E Martínez-Juárez Journal: Front Neurol Date: 2020-11-26 Impact factor: 4.003