title: Higher mortality rate is associated with advanced age and periodic lateralized epileptiform discharges in patients with refractory status epilepticus.
abstract: OBJECTIVE
  To evaluate clinical data, electroencephalogram, etiology, classification, treatment, morbidity, and mortality in acute refractory status epilepticus.
  
  
  METHODS
  Fifteen patients, mean age of 41.3 years-old, six males, with refractory status epilepticus, were retrospectively studied. All of them were followed by serial electroencephalogram or continuous electroencephalographic monitoring.
  
  
  RESULTS
  The most common comorbidity was hypertension. Seven (46.7%) patients were diagnosed with previous symptomatic focal epilepsy. More than one etiology was identified in 40.0% of the cases. Status epilepticus partial complex was the most common (n=14, 93.3%), and discrete seizures were the most observed initial ictal pattern. Continuous intravenous midazolam was used in nine (60.0%) patients and continuous thiopental in three (20.0%). Nine (60.0%) participants died, one (6.6%) had neurological sequelae, and five (33.3%) presented no neurological sequelae.
  
  
  CONCLUSIONS
  Higher mortality rate was associated with advanced age and periodic lateralized epileptiform discharges. Midazolam proved to be a safe drug. The refractory status epilepticus is related to high mortality.
authors.affiliation: Hospital São Paulo, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo SP, Brazil. paulo.neuroped@gmail.com
authors.forename: Paulo Breno Noronha
authors.initials: PB
authors.lastname: Liberalesso
authors.forename: Eliana
authors.initials: E
authors.lastname: Garzon
authors.forename: Elza M T
authors.initials: EM
authors.lastname: Yacubian
authors.forename: Américo C
authors.initials: AC
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000503:physiopathology; D012737:Sex Factors; D013226:Status Epilepticus / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D008874:Midazolam