Management of Status Epilepticus in the Neurology department of Specialties Hospital Center : about 66 cases.

Abstract

Introduction: Epilepsy is a public health problem, status epilepticus being its most severe and morbid expression. The objective of the study : The objective of this study was to describe the epidemiological, etiological, prognostic pro iles and the therapeutic attitudes applied during status epilepticus. Patients and Methods : We conducted a prospective study concerning 66 cases of status epilepticus hospitalized in the neurology department of the specialties hospital center on a 14 month period; From February 2019 to April 2020. Results : The ratio sex M / F was 1.2, the average was 42 years with extremes of 7 to 85 years, 62 % were known epileptics, 24 % were hypertensive, 15 % had a history of stroke, 9 % had postpartum course, 5 % had psychosis, 5 % had a history of head trauma, 3 % had neoplasia and 3 % had a course of diabetes. 23 or 35 % had focal EME, 22 or 33 % had EMETCG, 19 or 29 % had focal EME with secondary generalization and 2 or 3 % had myoclonic EME. 30 patients had an EEG, including 5 only in critical period and the others in post and intercritical. Postcritical EEG was normal in 8 patients. In 16 patients it showed paroxysmal abnormalities and slow epileptogenic abnormalities and in 6 patients slow non‑speci ic abnormalities. The brain scan was performed in 63 of our patients, and was found to be normal in 26 cases, in 15 % non‑systematized infarcts, in 11 % lacunar infarctions and deep hematomas, in 13 % showed a defect of opaci ication of durmerian sinus, a territorial infarction. The most frequent causes were vascular causes, ie 28.78 %, undetermined causes in 27.27 % and non compliance for antiepileptic drugs in 19.79 %. Symptomatic treatments were conditioning (lateral safety position), release of the upper airways, vascular illing, luid and electrolyte rehydration, temperature control, glycemic control, and corticosteroid therapy. The anti‑comitial treatment was started in all patients according to the following methods : benzodiazepines; injectable diazepam : 100 %, carbamazepine : 47 %, barbiturates : phenobarbital : 46 % of which only 36 % received the injectable form, sodium valproate : 36 %. Seizure control was achieved in 52 patients (78 %). The average length of stay was 8 days with extremes of 8 hours to 28 days, the mortality rate was 16 %. The most frequent causes were vascular diseases is 28.78 %, the average length of stay was 8 days with extremes of 8 hours to 28 days, the mortality rate was 16 %