title: Adult tonic-clonic convulsive status epilepticus over the last 11 years in a resource-poor country: a tertiary referral centre study from southern Thailand.
abstract: Status epilepticus is a common condition in patients admitted to hospital in resource-poor countries and reports indicate that aetiology, factors of poor outcome, and treatment strategies are variable. To date, there is no report of a prospective study in Thai adults. Herein, we investigated the aetiology, clinical features, factors of predicted poor outcome, and treatment strategies in Thai adult patients who presented with convulsive status epilepticus. A total of 180 patients, whose ages ranged from 15 to 106 years, were included. Of these, 121 patients (67.2%) had acute symptomatic aetiology. The most common aetiology of status epilepticus was encephalitis (36.1%), followed by scarring of the cerebral hemisphere (15%). The median duration of status epilepticus before treatment was three hours. The rate of mortality in the study was 26.7%. Poor outcome was identified in 112 (62.2%) patients. For referral patients, all received only intravenous drugs before referral. The variables that correlated with poor outcome were aetiology and duration of status epilepticus. An approach to incorporate improved prevention of encephalitis, a more effective transportation system, and provision of the essential intravenous antiepileptic drugs would effectively increase the response to treatment.
authors.affiliation: Neurology Unit, Department of Medicine.
authors.forename: Kanitpong
authors.initials: K
authors.lastname: Phabphal
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
authors.forename: Kitti
authors.initials: K
authors.lastname: Limapichart
authors.forename: Pornchai
authors.initials: P
authors.lastname: Sathirapanya
authors.forename: Suwanna
authors.initials: S
authors.lastname: Setthawatcharawanich
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D004830:Epilepsy, Tonic-Clonic / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000453:epidemiology* / Q000628:therapy; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants