الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 69 |  |  |
| | | from | 69 | | |
Abstract
Status epilepticus (SE) is a common, life-threatening neurologic disorder. It is essentially an acute, prolonged epileptic crisis. Several studies showed that the underlying etiology was a powerful predictor of mortality as well as the age of onset and the duration of seizure.
The aim of this study was designed to evaluate the prognostic factors and outcome in patients with status epilepticus .
This study was conducted on twenty patients admitted to to ICU unit of Alexandria Epilepsy Center in Elhadra Hospital and all Patients had status epilepticus according to operational definition as any seizure lasted for 30 minutes or longer, also two or more intermittent seizures lasting more than 30 minutes from which the patient did not regain consciousness. there were fifteen (75%) males and five (25%) female there ages ranged between nine to 65 years.
All patients were subjected to complete history taking, clinical examination , routine laboratory examination and the Modified Rankin Scale (MRS) as a functional outcome measure and the score was given prior to admission (based on information from relatives and carers) and at the time of discharge.
The results of the study showed:
There was significant difference as regard to age and prognosis of SE ,where increasing age was significantly associated with poor outcome. Patients were divided into two groups those above fifty years were three patients (15%) and below fifty years were seventeen patients (85%), prognosis was significantly better in younger age group. with only three patients out of seventeen had a bad prognosis on the other hand all the three patients above fifty had a bad prognosis.
There was no significant difference as regard to gender and prognosis of SE however there was tendency for females to had better prognosis. This may be attributed to the relatively younger age of females as their mean age was ( 17±6.36) compared to the mean age of males (29.60±18.71). There may be a true difference in seizure threshold related by hormonal influences.This may also be an explanation for the twofold increase in incidence of SE in males as compared with that in females. Another explanation for the gender difference in mortality is gender-specific differences in comorbid conditions
There was significant difference as regard to seizure type and prognosis of SE, where patients with partial with secondary generalized SE had a poor prognosis than patients with GCSE.
Idiopathic or cryptogenic etiology due to sudden antiepileptic drug withdrawal was the most frequent cause of SE.
There was significant difference as regard to different etiologies and prognosis of SE, this was particularly evident in stroke patients as all of them had bad prognosis.
There was no significant difference between pre existing epilepsy and prognosis of SE despite tending of patients with pre existing epilepsy to had better prognosis. The reason may be earlier detection and diagnosis, partial treatment from earlier anticonvulsants, or the absence of acute severe insults that worsen the prognosis in other patients.
There was significant difference as regard to the onset of seizure until admission, duration of seizure until cessation and time of stay in ICU and prognosis of SE, by which the longer the duration of seizure the poorer the outcome. delay to treatment initiation was predictive of poor outcome. It has been evidenced that prolonged seizures carries high risk of deleterious neurological and systemic complications.