1.Treatment outcome of status epilepticus in Thammasat University Hospital, Thailand
Kongkiat Kulkantrakorn ; Weraphan Moonman
Neurology Asia 2014;19(1):257-262
Background and Objective: Status epilepticus (SE) is an emergency condition with high mortality rate,
particularly in patients whose treatment is delayed. This is to describe clinical characteristics, treatment
process, and outcome and to determine clinical parameters which impact the SE outcome. Methods: This
was a descriptive study in 60 SE patients admitted between 2004-2011 to the Thammasat University
Hospital, Pathumthani, Thailand. The correlation between the outcome and clinical parameters was
analyzed. Results: Sixty SE patients were included (38 men; 22 women), mean age 55 years. Generalized
convulsive status epilepticus was the most common (55 events, 91.6%). Forty-three patients (71.7%)
had previous diagnosis of neurological disorders. AED withdrawal and old ischemic stroke were the
common causes of SE. The mean time from onset to treatment was 163.4 minutes and door to needle
time was 19.8 minutes. Diazepam and phenytoin were most commonly used as first and second line
AED. Eight patients (13%) developed refractory SE. The mortality rate was 25%, with 28.3% in total
dependent state, 20% had incomplete recovery, and 26.7% had complete recovery. The risk factors
which correlated with death were old age, long duration of seizure and coma.
Conclusion: In this cohort from north Bangkok and central Thailand, the mortality and morbidity rates
were high. More efforts should be taken to address the long delay to treatment, and other correctable
factors.
2.Treatment outcome of status epilepticus in Thammasat University Hospital, Thailand
Kongkiat Kulkantrakorn ; Weraphan Moonman
Neurology Asia 2014;19(3):257-262
Background and Objective: Status epilepticus (SE) is an emergency condition with high mortality rate, particularly in patients whose treatment is delayed. This is to describe clinical characteristics, treatment process, and outcome and to determine clinical parameters which impact the SE outcome. Methods: This was a descriptive study in 60 SE patients admitted between 2004-2011 to the Thammasat University Hospital, Pathumthani, Thailand. The correlation between the outcome and clinical parameters was analyzed. Results: Sixty SE patients were included (38 men; 22 women), mean age 55 years. Generalized convulsive status epilepticus was the most common (55 events, 91.6%). Forty-three patients (71.7%) had previous diagnosis of neurological disorders. AED withdrawal and old ischemic stroke were the common causes of SE. The mean time from onset to treatment was 163.4 minutes and door to needle time was 19.8 minutes. Diazepam and phenytoin were most commonly used as first and second line AED. Eight patients (13%) developed refractory SE. The mortality rate was 25%, with 28.3% in total dependent state, 20% had incomplete recovery, and 26.7% had complete recovery. The risk factors which correlated with death were old age, long duration of seizure and coma. Conclusion: In this cohort from north Bangkok and central Thailand, the mortality and morbidity rates were high. More efforts should be taken to address the long delay to treatment, and other correctable factors.
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