Clinical and paraclinical comparison of patients with refractory status epilepticus with non-refractory cases

Abstract

Status epilepticus is an emergency situation that can be life threatening. Refractory status epilepticus also refers to a condition in which seizure activity continues despite the use of benzodiazepines and another class of anticonvulsant drugs. In recent years, the incidence of this situation has increased. Epilepsy has high mortality and requires immediate treatment to control it. This study intends to help to better understand these two conditions and finally treat them in time by comparing the demographic conditions and the hospital outcomes of resistant and non-resistant persistent epilepsy. Methods: This study was done retrospectively. The file information of the patients referred to Razi and Imam Reza hospitals who were referred from the beginning of 2017 to 2022 were extracted. Finally, 300 patients were divided into two groups of resistant and non-resistant status epilepticus in terms of demographic data (age and gender of the patient) and clinical data including duration of status epilepticus, treatments used to control seizures, underlying causes in cases with refractory status epilepticus, EEG and brain MRI of patients, complications and mortality rate of patients were investigated. Results: There was no significant difference between the demographic data of the patients. There was no statistically significant difference in MRI findings between the two groups. 18.3% of patients had refractory status epilepsy. Among these patients, there was 36.4% mortality. Mortality in the status epilepsy group resistant to treatment was significantly higher than the non-resistant group (P-value: 0.001). Hospital complications and duration of hospitalization also occurred more in patients with refractory status epilepticus (P-value: 0.001).