Skip to main content
Erschienen in: Acta Neurologica Belgica 4/2023

03.06.2022 | Original article

Prognostic indicators of non-convulsive status epilepticus in intensive care unit

verfasst von: Kezban Aslan-Kara, Turgay Demir, Ümit Satılmış, Taylan Peköz, Şebnem Bıçakcı, Hacer Bozdemir

Erschienen in: Acta Neurologica Belgica | Ausgabe 4/2023

Einloggen, um Zugang zu erhalten

Abstract

Background

To determine the rate of non-convulsive status epilepticus with/without prominent motor phenomena (SE-PM/ NCSE) and predictive value of electroclinical findings of continious electroencephalography (cEEG) monitoring of these patients and its association with prognosis in intensive care units (ICU).

Methods

We retrospectively collected data of 218 patients whose cEEG was performed in ICU between 2016 and 2018. The cEEG for NCSE diagnosis was evaluated according to Salzburg Consensus Criteria (SCC).

Results

The mean age of patients was 57.09 ± 18.9 (16–95) years and 49.1% (107) were female. Of 218 patients, 32 (14.7%) had SE-PM/NCSE. According to SCC the rate of NCSE (NCSE + possible NCSE) was 9.6% (n = 21). Prior to cEEG recording, 38.9% (n = 85) of overall patients had a history of seizure/convulsion, and 22.7% (n = 21) of these patients diagnosed with NCSE based on cEEG. The mortality rates in critically ill patients were 41.3% (30.8%, 42.8%; for SE-PM and NCSE respectively). Prognosis was associated with age, epilepsy diagnosis, having convulsion/seizure history on follow-up, GCS, need for ventilation, kind of drugs, sepsis diagnosis, and minimum frequency of background activity of the cEEG (p = 0.001, 0.002, 0.001, 0.020, 0.001, 0.001, 0.001, 0.0001 respectively).

Conclusions

NCSE findings are mostly found in patients who were comatose and had seizure/convulsion history on follow-up. Mortality is higher in patients diagnosed with NCSE followed in the ICU compared to SE-PM.
Literatur
1.
Zurück zum Zitat Fogang Y, Legros B, Depondt C, Mavroudakis N, Gaspard N (2017) Yield of repeated intermittent EEG for seizure detection in critically ill adults. Neurophysiol Clin/Clin Neurophysiol 47:5–12CrossRef Fogang Y, Legros B, Depondt C, Mavroudakis N, Gaspard N (2017) Yield of repeated intermittent EEG for seizure detection in critically ill adults. Neurophysiol Clin/Clin Neurophysiol 47:5–12CrossRef
2.
Zurück zum Zitat Trinka E, Kälviäinen R (2017) 25 years of advances in the definition, classification and treatment of status epilepticus. Seizure 44:65–73CrossRefPubMed Trinka E, Kälviäinen R (2017) 25 years of advances in the definition, classification and treatment of status epilepticus. Seizure 44:65–73CrossRefPubMed
3.
Zurück zum Zitat Leitinger M, Trinka E, Giovannini G, Zimmermann G, Florea C, Rohracher A, Kalss G, Neuray C, Kreidenhuber R, Höfler J (2019) Epidemiology of status epilepticus in adults: a population-based study on incidence, causes, and outcomes. Epilepsia 60:53–62CrossRefPubMed Leitinger M, Trinka E, Giovannini G, Zimmermann G, Florea C, Rohracher A, Kalss G, Neuray C, Kreidenhuber R, Höfler J (2019) Epidemiology of status epilepticus in adults: a population-based study on incidence, causes, and outcomes. Epilepsia 60:53–62CrossRefPubMed
4.
Zurück zum Zitat Towne A, Waterhouse E, Boggs J, Garnett L, Brown A, Smith J, DeLorenzo R (2000) Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology 54:340–340CrossRefPubMed Towne A, Waterhouse E, Boggs J, Garnett L, Brown A, Smith J, DeLorenzo R (2000) Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology 54:340–340CrossRefPubMed
5.
Zurück zum Zitat Kang BS, Jhang Y, Kim Y-S, Moon J, Shin J-W, Moon HJ, Lee S-T, Jung K-H, Chu K, Park K-I (2014) Etiology and prognosis of non-convulsive status epilepticus. J Clin Neurosci 21:1915–1919CrossRefPubMed Kang BS, Jhang Y, Kim Y-S, Moon J, Shin J-W, Moon HJ, Lee S-T, Jung K-H, Chu K, Park K-I (2014) Etiology and prognosis of non-convulsive status epilepticus. J Clin Neurosci 21:1915–1919CrossRefPubMed
6.
Zurück zum Zitat DeLorenzo R, Hauser W, Towne A, Boggs J, Pellock J, Penberthy L, Garnett L, Fortner C, Ko D (1996) A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology 46:1029–1035CrossRefPubMed DeLorenzo R, Hauser W, Towne A, Boggs J, Pellock J, Penberthy L, Garnett L, Fortner C, Ko D (1996) A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology 46:1029–1035CrossRefPubMed
7.
Zurück zum Zitat Power KN, Gramstad A, Gilhus NE, Engelsen BA (2015) Adult nonconvulsive status epilepticus in a clinical setting: semiology, aetiology, treatment and outcome. Seizure 24:102–106CrossRefPubMed Power KN, Gramstad A, Gilhus NE, Engelsen BA (2015) Adult nonconvulsive status epilepticus in a clinical setting: semiology, aetiology, treatment and outcome. Seizure 24:102–106CrossRefPubMed
8.
Zurück zum Zitat Trinka E, Cock H, Hesdorffer D, Rossetti AO, Scheffer IE, Shinnar S, Shorvon S, Lowenstein DH (2015) A definition and classification of status epilepticus–report of the ILAE task force on classification of status epilepticus. Epilepsia 56:1515–1523CrossRefPubMed Trinka E, Cock H, Hesdorffer D, Rossetti AO, Scheffer IE, Shinnar S, Shorvon S, Lowenstein DH (2015) A definition and classification of status epilepticus–report of the ILAE task force on classification of status epilepticus. Epilepsia 56:1515–1523CrossRefPubMed
9.
Zurück zum Zitat Herman ST, Abend NS, Bleck TP, Chapman KE, Drislane FW, Emerson RG, Gerard EE, Hahn CD, Husain AM, Kaplan PW (2015) Consensus statement on continuous EEG in critically ill adults and children, part I: indications. J Clin Neurophysiol Off Publ Am Electroencephalogr Soc 32:87 Herman ST, Abend NS, Bleck TP, Chapman KE, Drislane FW, Emerson RG, Gerard EE, Hahn CD, Husain AM, Kaplan PW (2015) Consensus statement on continuous EEG in critically ill adults and children, part I: indications. J Clin Neurophysiol Off Publ Am Electroencephalogr Soc 32:87
10.
Zurück zum Zitat Claassen J, Taccone FS, Horn P, Holtkamp M, Stocchetti N, Oddo M (2013) Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM. Intensive Care Med 39:1337–1351CrossRefPubMed Claassen J, Taccone FS, Horn P, Holtkamp M, Stocchetti N, Oddo M (2013) Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM. Intensive Care Med 39:1337–1351CrossRefPubMed
11.
Zurück zum Zitat Rubinos C, Godoy D (2020) Electroencephalographic monitoring in the critically ill patient: What useful information can it contribute? Med Intensiva (Engl Ed) 44:301–309PubMed Rubinos C, Godoy D (2020) Electroencephalographic monitoring in the critically ill patient: What useful information can it contribute? Med Intensiva (Engl Ed) 44:301–309PubMed
12.
Zurück zum Zitat Leitinger M, Beniczky S, Rohracher A, Gardella E, Kalss G, Qerama E, Höfler J, Lindberg-Larsen AH, Kuchukhidze G, Dobesberger J (2015) Salzburg consensus criteria for non-convulsive status epilepticus–approach to clinical application. Epilepsy Behav 49:158–163CrossRefPubMed Leitinger M, Beniczky S, Rohracher A, Gardella E, Kalss G, Qerama E, Höfler J, Lindberg-Larsen AH, Kuchukhidze G, Dobesberger J (2015) Salzburg consensus criteria for non-convulsive status epilepticus–approach to clinical application. Epilepsy Behav 49:158–163CrossRefPubMed
13.
Zurück zum Zitat Fountain NB (2000) Status epilepticus: risk factors and complications. Epilepsia 41:S23–S30CrossRefPubMed Fountain NB (2000) Status epilepticus: risk factors and complications. Epilepsia 41:S23–S30CrossRefPubMed
14.
Zurück zum Zitat Kaplan PW (2003) Prognosis in nonconvulsive status epilepticus. Prognosis of epilepsies. John Libbey Eurotext, Paris, pp 311–325 Kaplan PW (2003) Prognosis in nonconvulsive status epilepticus. Prognosis of epilepsies. John Libbey Eurotext, Paris, pp 311–325
15.
Zurück zum Zitat Young BG, Jordan KG, Doig GS (1996) An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring: an investigation of variables associated with mortality. Neurology 47:83–89CrossRefPubMed Young BG, Jordan KG, Doig GS (1996) An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring: an investigation of variables associated with mortality. Neurology 47:83–89CrossRefPubMed
16.
Zurück zum Zitat Shneker BF, Fountain NB (2003) Assessment of acute morbidity and mortality in nonconvulsive status epilepticus. Neurology 61:1066–1073CrossRefPubMed Shneker BF, Fountain NB (2003) Assessment of acute morbidity and mortality in nonconvulsive status epilepticus. Neurology 61:1066–1073CrossRefPubMed
17.
Zurück zum Zitat Treiman DM, Meyers PD, Walton NY, Collins JF, Colling C, Rowan AJ, Handforth A, Faught E, Calabrese VP, Uthman BM (1998) A comparison of four treatments for generalized convulsive status epilepticus. N Engl J Med 339:792–798CrossRefPubMed Treiman DM, Meyers PD, Walton NY, Collins JF, Colling C, Rowan AJ, Handforth A, Faught E, Calabrese VP, Uthman BM (1998) A comparison of four treatments for generalized convulsive status epilepticus. N Engl J Med 339:792–798CrossRefPubMed
18.
Zurück zum Zitat Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, LaRoche SM, Riviello JJ, Shutter L, Sperling MR (2012) Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 17:3–23CrossRefPubMed Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, LaRoche SM, Riviello JJ, Shutter L, Sperling MR (2012) Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 17:3–23CrossRefPubMed
19.
Zurück zum Zitat Sinha SR, Sullivan LR, Sabau D, Orta DSJ, Dombrowski KE, Halford JJ, Hani AJ, Drislane FW, Stecker MM (2016) American clinical neurophysiology society guideline 1: minimum technical requirements for performing clinical electroencephalography. Neurodiagn J 56:235–244CrossRefPubMed Sinha SR, Sullivan LR, Sabau D, Orta DSJ, Dombrowski KE, Halford JJ, Hani AJ, Drislane FW, Stecker MM (2016) American clinical neurophysiology society guideline 1: minimum technical requirements for performing clinical electroencephalography. Neurodiagn J 56:235–244CrossRefPubMed
20.
Zurück zum Zitat Beniczky S, Hirsch LJ, Kaplan PW, Pressler R, Bauer G, Aurlien H, Brøgger JC, Trinka E (2013) Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia 54:28–29CrossRefPubMed Beniczky S, Hirsch LJ, Kaplan PW, Pressler R, Bauer G, Aurlien H, Brøgger JC, Trinka E (2013) Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia 54:28–29CrossRefPubMed
21.
Zurück zum Zitat Hirsch LJ, LaRoche SM, Gaspard N, Gerard E, Svoronos A, Herman ST, Mani R, Arif H, Jette N, Minazad Y, Kerrigan JF, Vespa P, Hantus S, Claassen J, Young GB, So E, Kaplan PW, Nuwer MR, Fountain NB, Drislane FW (2013) American clinical neurophysiology society’s standardized critical care EEG terminology: 2012 version. J Clin Neurophysiol 30:1–27CrossRefPubMed Hirsch LJ, LaRoche SM, Gaspard N, Gerard E, Svoronos A, Herman ST, Mani R, Arif H, Jette N, Minazad Y, Kerrigan JF, Vespa P, Hantus S, Claassen J, Young GB, So E, Kaplan PW, Nuwer MR, Fountain NB, Drislane FW (2013) American clinical neurophysiology society’s standardized critical care EEG terminology: 2012 version. J Clin Neurophysiol 30:1–27CrossRefPubMed
22.
Zurück zum Zitat Glauser T, Shinnar S, Gloss D, Alldredge B, Arya R, Bainbridge J, Bare M, Bleck T, Dodson WE, Garrity L (2016) Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline committee of the american epilepsy society. Epilepsy curr 16:48–61CrossRefPubMedPubMedCentral Glauser T, Shinnar S, Gloss D, Alldredge B, Arya R, Bainbridge J, Bare M, Bleck T, Dodson WE, Garrity L (2016) Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline committee of the american epilepsy society. Epilepsy curr 16:48–61CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Laccheo I, Sonmezturk H, Bhatt AB, Tomycz L, Shi Y, Ringel M, DiCarlo G, Harris D, Barwise J, Abou-Khalil B (2015) Non-convulsive status epilepticus and non-convulsive seizures in neurological ICU patients. Neurocrit Care 22:202–211CrossRefPubMed Laccheo I, Sonmezturk H, Bhatt AB, Tomycz L, Shi Y, Ringel M, DiCarlo G, Harris D, Barwise J, Abou-Khalil B (2015) Non-convulsive status epilepticus and non-convulsive seizures in neurological ICU patients. Neurocrit Care 22:202–211CrossRefPubMed
24.
Zurück zum Zitat Leitinger M, Trinka E, Gardella E, Rohracher A, Kalss G, Qerama E, Höfler J, Hess A, Zimmermann G, Kuchukhidze G (2016) Diagnostic accuracy of the Salzburg EEG criteria for non-convulsive status epilepticus: a retrospective study. Lancet Neurol 15:1054–1062CrossRefPubMed Leitinger M, Trinka E, Gardella E, Rohracher A, Kalss G, Qerama E, Höfler J, Hess A, Zimmermann G, Kuchukhidze G (2016) Diagnostic accuracy of the Salzburg EEG criteria for non-convulsive status epilepticus: a retrospective study. Lancet Neurol 15:1054–1062CrossRefPubMed
25.
Zurück zum Zitat Goselink RJ, van Dillen JJ, Aerts M, Arends J, van Asch C, van der Linden I, Pasman J, Saris CG, Zwarts M, van Alfen N (2019) The difficulty of diagnosing NCSE in clinical practice; external validation of the Salzburg criteria. Epilepsia 60:e88–e92CrossRefPubMedPubMedCentral Goselink RJ, van Dillen JJ, Aerts M, Arends J, van Asch C, van der Linden I, Pasman J, Saris CG, Zwarts M, van Alfen N (2019) The difficulty of diagnosing NCSE in clinical practice; external validation of the Salzburg criteria. Epilepsia 60:e88–e92CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Swisher CB, Shah D, Sinha SR, Husain AM (2015) Baseline EEG pattern on continuous ICU EEG monitoring and incidence of seizures. J Clin Neurophysiol 32:147–151CrossRefPubMed Swisher CB, Shah D, Sinha SR, Husain AM (2015) Baseline EEG pattern on continuous ICU EEG monitoring and incidence of seizures. J Clin Neurophysiol 32:147–151CrossRefPubMed
27.
Zurück zum Zitat Claassen J, Mayer S, Kowalski R, Emerson R, Hirsch L (2004) Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology 62:1743–1748CrossRefPubMed Claassen J, Mayer S, Kowalski R, Emerson R, Hirsch L (2004) Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology 62:1743–1748CrossRefPubMed
28.
Zurück zum Zitat Westover MB, Shafi MM, Bianchi MT, Moura LM, O’rourke D, Rosenthal ES, Chu CJ, Donovan S, Hoch DB, Kilbride RD (2015) The probability of seizures during EEG monitoring in critically ill adults. Clin Neurophysiol 126:463–471CrossRefPubMed Westover MB, Shafi MM, Bianchi MT, Moura LM, O’rourke D, Rosenthal ES, Chu CJ, Donovan S, Hoch DB, Kilbride RD (2015) The probability of seizures during EEG monitoring in critically ill adults. Clin Neurophysiol 126:463–471CrossRefPubMed
29.
Zurück zum Zitat Trinka E, Leitinger M (2015) Which EEG patterns in coma are nonconvulsive status epilepticus? Epilepsy Behav 49:203–222CrossRefPubMed Trinka E, Leitinger M (2015) Which EEG patterns in coma are nonconvulsive status epilepticus? Epilepsy Behav 49:203–222CrossRefPubMed
30.
Zurück zum Zitat Yuan F, Yang F, Li W, Yang X, Gao Q, Bi L, Jiang Y, Jiang W (2018) Nonconvulsive status epilepticus after convulsive status epilepticus: Clinical features, outcomes, and prognostic factors. Epilepsy Res 142:53–57CrossRefPubMed Yuan F, Yang F, Li W, Yang X, Gao Q, Bi L, Jiang Y, Jiang W (2018) Nonconvulsive status epilepticus after convulsive status epilepticus: Clinical features, outcomes, and prognostic factors. Epilepsy Res 142:53–57CrossRefPubMed
31.
Zurück zum Zitat Koutroumanidis M, Sakellariou D (2015) Low frequency nonevolving generalized periodic epileptiform discharges and the borderland of hypoxic nonconvulsive status epilepticus in comatose patients after cardiac arrest. Epilepsy Behav 49:255–262CrossRefPubMed Koutroumanidis M, Sakellariou D (2015) Low frequency nonevolving generalized periodic epileptiform discharges and the borderland of hypoxic nonconvulsive status epilepticus in comatose patients after cardiac arrest. Epilepsy Behav 49:255–262CrossRefPubMed
32.
Zurück zum Zitat Shafi MM, Westover MB, Cole AJ, Kilbride RD, Hoch DB, Cash SS (2012) Absence of early epileptiform abnormalities predicts lack of seizures on continuous EEG. Neurology 79:1796–1801CrossRefPubMedPubMedCentral Shafi MM, Westover MB, Cole AJ, Kilbride RD, Hoch DB, Cash SS (2012) Absence of early epileptiform abnormalities predicts lack of seizures on continuous EEG. Neurology 79:1796–1801CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Struck AF, Osman G, Rampal N, Biswal S, Legros B, Hirsch LJ, Westover MB, Gaspard N (2017) Time-dependent risk of seizures in critically ill patients on continuous electroencephalogram. Ann Neurol 82:177–185CrossRefPubMedPubMedCentral Struck AF, Osman G, Rampal N, Biswal S, Legros B, Hirsch LJ, Westover MB, Gaspard N (2017) Time-dependent risk of seizures in critically ill patients on continuous electroencephalogram. Ann Neurol 82:177–185CrossRefPubMedPubMedCentral
Metadaten
Titel
Prognostic indicators of non-convulsive status epilepticus in intensive care unit
verfasst von
Kezban Aslan-Kara
Turgay Demir
Ümit Satılmış
Taylan Peköz
Şebnem Bıçakcı
Hacer Bozdemir
Publikationsdatum
03.06.2022
Verlag
Springer International Publishing
Erschienen in
Acta Neurologica Belgica / Ausgabe 4/2023
Print ISSN: 0300-9009
Elektronische ISSN: 2240-2993
DOI
https://doi.org/10.1007/s13760-022-01981-6

Weitere Artikel der Ausgabe 4/2023

Acta Neurologica Belgica 4/2023 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Schwindelursache: Massagepistole lässt Otholiten tanzen

14.05.2024 Benigner Lagerungsschwindel Nachrichten

Wenn jüngere Menschen über ständig rezidivierenden Lagerungsschwindel klagen, könnte eine Massagepistole der Auslöser sein. In JAMA Otolaryngology warnt ein Team vor der Anwendung hochpotenter Geräte im Bereich des Nackens.

Schützt Olivenöl vor dem Tod durch Demenz?

10.05.2024 Morbus Alzheimer Nachrichten

Konsumieren Menschen täglich 7 Gramm Olivenöl, ist ihr Risiko, an einer Demenz zu sterben, um mehr als ein Viertel reduziert – und dies weitgehend unabhängig von ihrer sonstigen Ernährung. Dafür sprechen Auswertungen zweier großer US-Studien.

Bluttest erkennt Parkinson schon zehn Jahre vor der Diagnose

10.05.2024 Parkinson-Krankheit Nachrichten

Ein Bluttest kann abnorm aggregiertes Alpha-Synuclein bei einigen Menschen schon zehn Jahre vor Beginn der motorischen Parkinsonsymptome nachweisen. Mit einem solchen Test lassen sich möglicherweise Prodromalstadien erfassen und die Betroffenen früher behandeln.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.