Clinical outcomes following prolonged refractory status epilepticus (PRSE)

R. D. Kilbride, A. S. Reynolds, J. P. Szaflarski, L. J. Hirsch

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Background: To define the clinical profile and outcome of patients in prolonged refractory status epilepticus (PRSE), and investigate possible predictors of outcome. Methods: We reviewed 63 consecutive patients with PRSE cared for in the medical and neurointensive care units of three academic medical centers over a 9-year period. For this multi-center retrospective cohort study, PRSE was defined as SE that persisted despite at least 1 week of induced coma. Variables examined for their relationship to outcome included etiology, EEG, neuroimaging, and age. Results: Forty-two (66 %) of 63 patients in PRSE survived to discharge from hospitalization. Fourteen (22 %) patients had a good outcome (mRS ≤ 3) at last available follow up (at least 6 months post-PRSE). Of these, 6 (10 %) individuals had no significant disability and were able to carry out all usual activities (mRS = 1). Normal neuroimaging and a reactive EEG at onset of PRSE were associated with good outcome. Good or excellent clinical outcomes were possible in patients in PRSE for up to 79 days, and in patients up to 69 years old. Conclusions: Good outcome is not unusual in PRSE, including in some older patients, in a variety of diagnoses, and despite months of coma.

Original languageEnglish
Pages (from-to)374-385
Number of pages12
JournalNeurocritical Care
Volume18
Issue number3
DOIs
StatePublished - Jun 2013
Externally publishedYes

Keywords

  • Neuro ICU
  • Outcomes
  • PRSE
  • Status epilepticus

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