Abstracts

Rationale: The new definition of SE includes times (t1-t2) adapted to each type, however t2 is not clearly defined in focal SE with impaired level of consciousness nor in the rest of NCSE. We aimed to evaluate the prognosis of patients with these types of SE, regarding the timing of treatment and resolution. Methods: We evaluated all patients prospectively collected in two centers with a diagnosis of focal SE with impaired level of consciousness and NCSE with a preserved level of consciousness. Demographic profile, etiology, treatment used, different timings (time to first treatment, EEG,  total resolution of SE –duration-), prognosis at discharge and long term were collected. Results: From Dec-2012 to May-2017, a total of 74 focal SE with impaired consciousness and 66 NCSE with a preserved mental state were included in the registry. In the first group the median age was 72yo and 60.8% were male. Regarding prognosis, it was significantly worse in women (p=0.02), older age (p=0.044) and in the absence of previous epilepsy (p=0.02). In addition, it was also associated with a potentially fatal etiology(PFE) (p=0.02),  the mSTESS (p=0.003) and an in-hospital debut (p=0.017). When analyzing timings we found that a SE duration > 5 hours was associated with a worse prognosis (p=0.008). After a logistic regression, the prognosis was independently associated with a duration > 5 hours (p=0.010), in addition to etiology (p = 0.012) and mSTESS (p = 0.004). SE duration was related to the time to the first antiepileptic treatment as well as the time of an adequate neurological assessment. The second group had a median age of 68yo, 47% of them were male. The prognosis was significantly worse in the absence of previous epilepsy (p=0.004) and at older age (p=0.036). mSTESS (p=0.0001), PFE (p=0.0001), the presence of PLDs (p=0.035) and and in-hospital debut (p = 0.005) were also associated. Regarding timings, a duration> 42 hours was clearly associated with a worse prognosis (p=0.0001). After a multivariate analysis,  a duration> 42h (p=0.008), PFE (p=0.007) and mSTESS (p=0.013) remained as independent factors. SE duration was also related to the time to the first treatment and to the EEG performance . In both cases, a worst functional prognosis remained at long-term. Conclusions: In both SE types (focal with impaired level of consciousness and NCSE without impaitment of consciousness) prognosis depends on etiology, mSTESS and duration. The poorer prognosis was maintained at long-term follow-up. Therefore in the first group a t2 of 5h might be considered and in  the second group 42h. Funding: No funding