Ictal EEG: Etiology and Mortality in Older Adults With Nonconvulsive Status Epilepticus.

IF 1.6 4区 医学 Q3 CLINICAL NEUROLOGY Clinical EEG and Neuroscience Pub Date : 2024-03-01 Epub Date: 2023-07-27 DOI:10.1177/15500594231183554
Glória M A S Tedrus
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Abstract

Clinical-electroencephalogram (EEG), as well as etiological and prognostic data on subtypes of nonconvulsive status epilepticus (NCSE) are yet to be established. Objective: Evaluate the clinical semiology and EEG findings and prognostic data of older adults with NCSE. Methodology: Characterize the clinical-EEG and prognostic data in the subtypes of NCSE in older adults consecutively admitted to the emergency room of the Pontifícia Universidade Católica de Campinas (PUC-Campinas) University Hospital. Results: When evaluating 105 older adults with altered consciousness, it was possible to diagnose NCSE in 50 (47.6%) older adults, with a mean age of 72.8 ± 8.8 years. NCSE-coma occurred in 6 cases, with NCSE-without coma in 44 cases. The etiology was structural in 41(82%) cases, metabolic in 5 cases, and unknown etiology in 4 cases. Twelve cases had a history of epileptic seizures. On the EEG, epileptiform discharges (EDs > 2.5 Hz) were present in 34(68%) cases and rhythmic delta activity /lateralized periodic patterns occurred in 35(70%) cases. There was clinical improvement after the initial pharmacological treatment in 36 cases and, within 30 days, 18 cases died. The better prognosis was associated with a good response to initial pharmacological treatment (n = 14) and with EDs > 2.5 Hz on EEG (Fisher's exact test; 26 vs 8; P = .012). Conclusion: Focal NCSE with impaired consciousness was the most frequent subtype. The most frequent finding on the EEG was the recording of focal/regional seizures. A high number of cases showed initial clinical improvement, but mortality was high. The favorable prognosis was associated with initial clinical improvement and the presence of EDs > 2.5 Hz. There was no relationship between EEG patterns and the etiology and subtypes of NCSE in older adults.

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异位脑电图:老年非惊厥性癫痫状态患者的病因和死亡率。
关于非惊厥性癫痫(NCSE)亚型的临床脑电图(EEG)、病因学和预后数据尚未确定。研究目的评估患有 NCSE 的老年人的临床半身像和脑电图结果以及预后数据。方法:对临床-脑电图的特征进行分析:分析坎皮纳斯天主教大学(PUC-Campinas)大学医院急诊室连续收治的 NCSE 亚型老年人的临床、EEG 和预后数据。研究结果在对 105 名意识改变的老年人进行评估时,有 50 名(47.6%)老年人被诊断为 NCSE,平均年龄为 72.8 ± 8.8 岁。6例发生了NCSE-昏迷,44例发生了NCSE-无昏迷。41例(82%)病因是结构性的,5例是代谢性的,4例病因不明。12 例患者有癫痫发作史。在脑电图上,34 例(68%)患者出现痫样放电(EDs > 2.5 Hz),35 例(70%)患者出现节律性三角活动/偏侧周期性模式。有 36 例患者在接受初始药物治疗后临床症状有所改善,但有 18 例患者在 30 天内死亡。较好的预后与对初始药物治疗的良好反应(n = 14)和脑电图上 EDs > 2.5 Hz 有关(费雪精确检验;26 vs 8;P = .012)。结论伴有意识障碍的局灶性 NCSE 是最常见的亚型。脑电图最常见的发现是记录到局灶性/区域性癫痫发作。很多病例在初期临床症状有所改善,但死亡率很高。良好的预后与最初的临床改善和ED > 2.5 Hz有关。老年人的脑电图模式与 NCSE 的病因和亚型之间没有关系。
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来源期刊
Clinical EEG and Neuroscience
Clinical EEG and Neuroscience 医学-临床神经学
CiteScore
5.20
自引率
5.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Clinical EEG and Neuroscience conveys clinically relevant research and development in electroencephalography and neuroscience. Original articles on any aspect of clinical neurophysiology or related work in allied fields are invited for publication.
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