Status Epilepticus in Third-Level Neurological Center: A Cross-Sectional Study in Mexico City
Jonathan Macias Lopez1, Irene Gomez Oropeza1, Diego Pichardo Rojas1, Karen Janely Camarena-Rubio1, Fernanda Castelo Pablos1, Valeria Bravo Osorno1, Sonia Mejia-Perez2, Elma Paredes-Aragón1
1Epilepsy Clinic, 2Neurosurgery, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suarez"
Objective:
We present the characteristics and treatment outcomes in a sample of SE patients from a large Neurological Center in Mexico City.
Background:
Status epilepticus (SE) is defined as a seizure lasting ≥5 minutes or a series of seizures in rapid succession without complete neurological recovery to baseline. Little is known about demographic characterization of patients that develop SE in Mexico.
Design/Methods:
In this retrospective cross-sectional cohort we included patients 18 years old or older, with SE, recruited at the National Institute of Neurology and Neurosurgery in Mexico City. We compiled patients baseline characteristics, and SE outcomes. Admission severity was calculated with Status Epilepticus Severity Score (STESS). Functional status at discharge was described using the modified Rankin Scale (mRS).
Results:
Between June and December 2023, 47 patients with SE were included in the study. The majority were female (57.4%), with a median age of 42 years. Infectious diseases were the most common cause of SE (34%), followed by anti-seizure medication (ASM) discontinuation and stroke.
Most patients had a history of epilepsy (66%), and nearly half had experienced SE previously (29%). Despite this, only 31 patients were successfully treated with second-line SE ASMs, and 11 with third-line treatments. This highlights the complexity of cases seen at the center.
In-hospital mortality was 8.5%, and 17% of patients required intensive care unit admission. The median hospital stay was 4 days, but it could be significantly longer for those in the ICU.
Functional outcomes at discharge were assessed using the modified Rankin Scale (mRS). While 42.55% of patients had favorable outcomes, 44.6% had significant neurological disability.
Conclusions:
This study provides valuable insights into the characteristics and outcomes of SE patients in Mexico. Larger studies are needed to better understand the epidemiology and management of SE in Latin American populations.
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