title: Status epilepticus in scrub typhus.
abstract: Scrub typhus is an emerging infection, and there is little information about status epilepticus (SE) in scrub typhus. We report the clinical spectrum and outcome of SE in scrub typhus. In a 3-year prospective hospital-based observational study, all scrub typhus patients with SE were included. Scrub typhus was diagnosed by immunochromatography assay. SE was defined if convulsions lasted longer than 5 min. The patients' demographic, clinical, computed tomography (CT), magnetic resonance imaging (MRI), and electroencephalography (EEG) findings were noted. Response to antiepileptic drugs (AEDs) and outcome at 1 month and 1 year were recorded. Between 2012 and 2014, there were 66 patients with scrub typhus admitted with central nervous system (CNS) involvement, 10 (15.2%) of whom had SE (generalized convulsions in 5, secondary generalized in one). The median age of the patients was 34 (range 18-71) years and seven were female. The duration of SE ranged between 10 min and 48 h. SE responded to one AED in five patients, two AEDs in three patients, and more than two AEDs in two patients. Cranial MRI findings were normal. All patients recovered completely with doxycycline by 1 month and AED was withdrawn by 8 months in all. Although 15% patients with scrub typhus may have SE, they have good outcome.
authors.affiliation: Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Jayantee
authors.initials: J
authors.lastname: Kalita
authors.affiliation: Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Vinita E
authors.initials: VE
authors.lastname: Mani
authors.affiliation: Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Sanjeev K
authors.initials: SK
authors.lastname: Bhoi
authors.affiliation: Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Usha K
authors.initials: UK
authors.lastname: Misra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008140:Lorazepam / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012612:Scrub Typhus / Q000150:complications*; D013226:Status Epilepticus / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology*; D016896:Treatment Outcome; D017361:Viral Nonstructural Proteins / Q000276:immunology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D017361:Viral Nonstructural Proteins; D008140:Lorazepam
keywords: Antiepileptic drugs; EEG; Infection; Scrub typhus; Status epilepticus