Abstracts

Rationale: Status Epilepticus is a serious condition with high mortality and morbidity which has been studied extensively for the identification of risk factors and best treatment modalities. However, few studies have looked at outpatient follow up after status epilepticus. Methods: A retrospective analysis of patients admitted to the Detroit Medical Center system in status epilepticus over the course of two consecutive years was carried out. Patient demographics, patient history, clinical course, AED regimens, and patient outcomes were recorded in a systemic fashion. Electronic medical records were reviewed for each admission in status epilepticus, their latency, and seizure frequency at follow up in the Epilepsy Clinic, and their AED regimen at discharge and follow-up appointment. Seizure frequency at follow up was defined as number of seizures per week. Results: A total of 125 patients and 210 admissions in status epilepticus were reviewed. Only 28% of patients (36/125) and 27% (57/210) of the total admissions had follow up (FU). The total cohort of patients with FU (n = 36) were broken down into four separate categories based on etiology of status epilepticus: documented history of epilepsy (n =14); known remote cause: previous subdural hemorrhage, stroke, resection, or subarachnoid hemorrhage (n = 9); known acute cause: new stroke, infection, TBI, alcohol related, or noncompliance with AEDs (n =10); and lastly known progressive causes: tumors, dementia, neurosarcoidosis, autoimmune encephalitis (n=3). Of these patients, median latency to follow up was 15wks (Interquartile range 38wks 4d) with a median of 0.25 seizures per week (Interquartile range 0.94) at FU. Time to FU was inversely related to seizure frequency in this group (p < 0.05). The most commonly used AEDs on any given regimen on both discharge (DC) and FU were levetiracetam and lacosamide. However, the average number of AEDs in any given regimen stayed consistent at 2.17 (DC) and 2.12 (FU). Conclusions: We provide a single center retrospective data analysis of admissions in status epilepticus looking from the lens of a follow-up perspective. Our study consisted of patients with a wide variety of etiologies of status epilepticus with variable follow-up rates. Overall outpatient follow up was low. Patients who did follow up in the outpatient were refractory with monthly seizures on an average of two medications. Those who had a shorter latency to their outpatient visits had a significantly lower average number of seizures which underlines the importance of continued care after the resolution of status epilepticus. Funding: No funding