Electrographic seizure duration and inter-seizure intervals in focal status epilepticus.

Autor: Meletti S; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy., Turchi G; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy., Orlandi N; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy., Vaudano AE; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy., Cioclu MC; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.; Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy., Pugnaghi M; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy., Giovannini G; Neurology Department, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.; PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio-Emilia, Modena, Italy.
Jazyk: angličtina
Zdroj: Epileptic disorders : international epilepsy journal with videotape [Epileptic Disord] 2023 Aug; Vol. 25 (4), pp. 519-527. Date of Electronic Publication: 2023 May 16.
DOI: 10.1002/epd2.20071
Abstrakt: Objective: To characterize the duration of seizures and inter-seizure intervals in focal status epilepticus (SE).
Methods: We reviewed consecutive scalp EEG recordings from adult patients who were admitted for a first episode of focal status epilepticus. We identified electrographic seizure duration and inter-seizure intervals in the first diagnostic pretreatment EEG. We also reviewed isolated focal self-limiting seizures in epilepsy patients, as a comparison group for seizure duration.
Results: We recorded 307 focal seizures in 100 consecutive focal SE episodes, with a median seizure duration of 107 s (IQR: 54-186), and 134 isolated focal self-limiting seizures in 42 epilepsy patients, with a median duration of 59 s (IQR: 30-90; p < .001). The only clinical feature of SE that significantly increased seizure duration was acute symptomatic etiology. In SE, 15% and 7% of seizures lasted longer than 300 and 600 s, respectively (t1 of the actual definition for tonic-clonic and focal SE), while only 1% of self-limiting seizures lasted longer than 300 s, and none lasted longer than 600 s. The analysis of inter-seizure intervals in SE with multiple seizures showed that 50% of the inter-seizure periods were shorter than 60 s, and 95% were shorter than 540 s (9 min). Patients who had an increase in seizure duration (last versus first) of at least 1.4 times showed an increased 30-day mortality.
Significance: Focal seizures within a SE episode showed a wide range of duration, partly overlapping with the duration of focal self-limiting seizures but with a longer median duration. Inter-seizure intervals within an episode of SE were shorter than 1 min in 50% of the seizures and never lasted more than 10 min. Finally, an increase in seizure duration could represent an "electrophysiological biomarker" of a more severe SE episode, which may require more aggressive and rapid treatment.
(© 2023 The Authors. Epileptic Disorders published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
Databáze: MEDLINE
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