OBJECTIVE:Determine Incidence and Clinical outcome of Non Convulsive Status Epilepticus(NCSE) in Neuro and Medical ICU patients.BACKGROUND:NCSE is under recognized in critically ill patients and associated with significant morbidity and mortality.It often is only diagnosed with continous EEG monitoring.DESIGN/METHODS:Retrospective chart review study.Instituional IRB approval obtained.The EEG registry at University of Minnesota Medical Center was used to identify adult patients who underwent continuous EEG monitoring for at least 2 days in a Neuro or Medical ICU setting between 2005 and 2013. Exclusion criteria: Normal EEGEnd point:Discharge from hospital or death.Modified Rankin scale was used as a clinical outcome measure.SPSS was used for statistical analysisRESULTS:23.9%(21/88)were diagnosed with NCSE during continous EEG monitoring(19 of these 21 patients were in coma or stupor).Only 5 of these 21 patients had a known diagnosis of Epilepsy.Most common etiology in patients with NCSE was structural or traumatic brain injuries,(brain tumor,shunt malfunction,vascular malformation,subdural hematomas,traumatic SAH etc) followed by vascular and metabolic etiologies(9,4 and 4 patients respectively) only 1 patient had convulsive status epilepticus preceding NCSE.Patients diagnosed with NCSE did not have a worse clinical outcome per modified rankin scale(MRS)(p value 0.666),whereas patients in a state of stupor/coma(per clinical exam)did have a worse clinical outcome(p value < 0.005).CONCLUSIONS:NCSE was diagnosed in nearly one of four critically ill patients who underwent continous EEG most of whom did not have a prior diagnosis of Epilepsy.Most common etiology in the NCSE group was structural or traumatic brain injuries followed by vacular and metabolic etiologies.It was not clear that diagnosing NCSE changed clinical outcome in these patients.More studies including multicenter trials are needed to focus on Non convulsive status in critically ill patients.Study Supported by:Department of Neurology,University of Minnesota
Disclosure: Dr. Tom has nothing to disclose. Dr. Fiol-Elias has nothing to disclose.
Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/P1.271?rss=1
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