Status epilepticus: clinical presentation, cause, outcome, and predictors of death in 119 Ethiopian patients.
OBJECTIVE
Status epilepticus (SE) is a common neurological emergency with high morbidity and mortality. There is no study that has been conducted among Ethiopian patients with SE. The purpose of this study was to analyze clinical presentation, causes, complications, outcomes, and predictors of mortality.


METHODS
In this retrospective study, patients aged >or=13 year with SE were included. Medical records were reviewed and demographic and clinical data were collected.


RESULTS
Records of 119 patients were analyzed; preexisting epilepsy was found in 38.7%. Primarily generalized and focal with secondarily generalized (FWSG) seizures were identified in 60.5% and 36%, respectively. Simple partial SE occurred in 3.4%. Central nervous system (CNS) infection was the most common cause of SE in the whole group as well as in those with new onset seizure. Antiepileptic drug withdrawal (AEDW) was the main cause in those with preexisting seizure. One or more complications were detected in 61%. Intravenous diazepam and oral phenytoin were given to 95% and 97.5%, respectively. Case fatality was 20.2%; poor outcome occurred in 24%. Predictors of mortality were FWSG type, acute symptomatic etiology, stroke, systemic infection, and HIV/AIDS and its CNS complications. Idiopathic and SE due to AEDW were associated with good prognosis.


CONCLUSIONS
CNS infection was the most common cause of SE in the whole group and AEDW was the major cause in patients with preexisting epilepsy. Parenteral anticonvulsants, emergency measurement of serum AED level, and electroencephalography for urgent diagnosis and monitoring were unavailable. Mortality was related to underlying etiologies especially HIV/AIDS and its CNS complications.
Amare
Amanuel
A
Medical Faculty, Department of Neurology, Addis Ababa University, Addis Ababa, Ethiopia. amanuelaw@yahoo.com
Zenebe
Guta
G
Hammack
Julie
J
Davey
Gail
G
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D002423:Cause of Death; D004660:Encephalitis / Q000150:complications; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013226:Status Epilepticus / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D020521:Stroke / Q000150:complications; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D016896:Treatment Outcome
D000927:Anticonvulsants