Authors :
Presenting Author: Salvador Martinez-Medina, MD – National Institute of Neurology and Neurosurgery
Pilar Robles-Lomelin, MD – National Institute of Neurology and Neurosurgery
Oscar Augusto Esquivel-Zapata, MD – National Institute of Neurology and Neurosurgery
Jonathan Macias-Lopez, MD – National Institute of Neurology and Neurosurgery
Elma Paredes-Aragon, MD – National Institute of Neurology and Neurosurgery
Rationale:
The etiologies of status epilepticus (SE) are highly heterogeneous and often difficult to identify. The aetiology of SE is considered a critically important prognostic factor, especially in functional and vital outcomes. In most cases, the correct identification of the aetiology in SE justifies the implementation of a specific treatment to halt its progression. The objective of this study was to describe the frequency of etiologies for the development of status epilepticus in a Mexican population treated at a specialised neurology referral centre.
Methods:
Observational, descriptive, and retrospective study. Patients over 15 years of age diagnosed with status epilepticus and treated during 2023 in the emergency department of the INNN were included. Clinical and demographic variables were obtained from the clinical records. Statistical analysis was performed using SPSS 25 software.
Results:
Out of 54 patients included, 53% (n=29) were women, with a mean age of 42.2 years. 42% (n=23) had a prior diagnosis of epilepsy, and an average hospital stay of 12.6 days was reported. The most common SE aetiology identified in our population was infectious in 33.3% (n=18). Other identified etiological factors included poor adherence to treatment (11.1%), immune-mediated causes (11.1%), cerebrovascular disease (9.2%), metabolic causes (7.4%), unknown aetiology (11.1%) and other causes (16.6%). When making an aetiology comparison between SE and refractory SE, it was observed that no patients with resolved SE had an immune-mediated aetiology (0% in SE and 28.5% in RSE, p=0.03).
Conclusions:
In status epilepticus, knowledge of factors predicting outcomes is crucial. Infectious aetiology remains the most common cause of SE in our population; however, it is important to consider other less-studied etiologies such as immune-mediated causes. The description of the main etiologies of SE in our population will allow for the establishment of more effective diagnostic algorithms for early identification and determination of targeted treatment, aiming to reduce mortality and the risk of recurrence.
Funding: None