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Baysal-Kirac, Leyla; Feddersen, Berend; Einhellig, Marion; Remi, Jan; Noachtar, Soheyl (2018): Does semiology of status epilepticus have an impact on treatment response and outcome? In: Epilepsy & Behavior, Vol. 83: pp. 81-86
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Objective: This study investigated whether there is an association between semiology of status epilepticus (SE) and response to treatment and outcome. Method: Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2 +/- 17.5 (18-97) years. Patient demographics, SE semiology and electroencephalography (EEG) findings, etiology, duration of SE, treatment, and outcome measures were investigated. Status epilepticus semiology was classified according to a semiological status classification. Patient's short-term outcome was determined by Glasgow Outcome Scale (GOS). Results: The most frequent SE type was nonconvulsive SE (NCSE) (39.2%), mostly associated with cerebrovascular etiology (46.6%). A potentially fatal etiology was found in 34.8% of the patients. More than half (60.7%) of the patients had poor short-term outcome (GOS <= 3) with an overall mortality of 12.4%. SE was refractory to treatment in 21.5% of the patients. Older age, potentially fatal etiology, systemic infections, NCSE in coma, refractory SE, treatment with anesthetics, long SE duration (>24 h), low Glasgow Coma Scale (GCS) (<= 8) at onset, and high Status Epilepticus Severity Score (STESS-3) (>= 3) were associated with poor short-term outcome and death (p < 0.05). Potentially fatal etiology and low GCS were the strongest predictors of poor outcome (Exp[b]: 4.74 and 4.10 respectively, p < 0.05). Conclusion: Status epilepticus semiology has no independent association with outcome, but potentially fatal etiology and low GCS were strong predictive factors for poor short-term outcome of SE.