Predictors and outcome of status epilepticus in cerebral venous thrombosis
We report the clinico-radiological characteristics of SE in the patients with cerebral venous thrombosis (CVT), and compare the relative risk of SE in determining death and disability compared with those patients with and without self-limiting seizures. Consecutive patients with magnetic resonance venography (MRV) confirmed CVT, admitted during 2006–2017, were included. Their clinical details, risk factors, and magnetic resonance imaging and MRV findings were noted. Duration of SE, Status Epilepticus Severity Score (STESS), Glasgow Coma Scale score, and response to antiepileptic drugs were noted. 6-month outcomes were noted using the modified Rankin Scale. Of 153 CVT patients, 28 (18.3%) had SE, 62 (40.5%) self-limiting seizures, and 63 (41.2%) did not have seizures or SE. The SE group had a higher incidence of focal motor deficit (71.4% vs. 33%, P = 0.006) and supratentorial lesions (93% vs 55.5%, P = 0.003) than the no-seizure group. Multivariate analysis of SE and no-SE group (includes self-limiting and no seizure) did not indicate any significant predictor, but multivariate analysis of SE and no-seizure group indicated that supratentorial lesion only predicted SE (odds ratio 5.65, 95% confidence interval 1.11–28.76; P = 0.03). Patients with SE and self-limiting seizure had similar clinical and MRI findings. In total, 17.8% had refractory SE; refractoriness was related to the pretreatment duration of SE (P < 0.001). The death and disability were not significantly different between the three groups. At 6 months, 84% patients with SE, 92.3% with self-limiting seizure, and 94.8% in no-seizure group had good recovery.
KeywordsAcute symptomatic seizure Unprovoked seizure Refractory status epilepticus MRI Death Outcome
We thank Dr. SK Mandal for statistical analysis and Mr. Shakti Kumar for secretarial help. We are grateful to Elenka Rodrigues for language editing which was supported by Sanofi. The authors individually and collectively are responsible for all contents and editorial decisions and received no payment from any agency directly or indirectly (through a third party) related to the development/presentation of this publication.
JK: planning, writing & analysis. UKM: planning & work management. VKS and DD: data collection & statistical analysis.
This research is investigator initiated and did not receive any grant from the public, commercial, or not-for-profit sector funding agencies.
Compliance with ethical standards
Conflicts of interest
None of the authors has any conflict of interest.
We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. Statistical analysis conducted by Dr. SK Mandal (Statistician of Centre for Biomedical Research at SGPGIMS, Lucknow, India).
- 5.Knake S, Rosenow F, Vescovi M, Oertel WH, Mueller HH, Wirbatz A, Katsarou N, Hamer HM, Status Epilepticus Study Group Hessen (SESGH) (2001) Status epilepticus study group hessen (SESGH) incidence of status epilepticus in adults in Germany: a prospective, population-based study. Epilepsia 42:714–718CrossRefGoogle Scholar
- 9.Zohair NA, Mansoor I, Uzma J, Sumaira N, Mughal Shahzad (2015) Etiology of stroke in young Pakistani adults; results of a single center study. Pakistan J Neurol Sci (PJNS) 10Google Scholar
- 11.Bousser MG, Russell RR (1997) Cerebral venous thrombosis. In: Warlow CP, Van Gijn J (eds) Major problems in neurology. WB Saunders, London, pp 25–140Google Scholar
- 13.Beghi E, D’Alessandro R, Beretta S, Consoli D, Crespi V, Delaj L, Gandolfo C, Greco G, La Neve A, Manfredi M, Mattana F, Musolino R, Provinciali L, Santangelo M, Specchio LM, Zaccara G, Epistroke Group (2011) Incidence and predictors of acute symptomatic seizures after stroke. Neurology 77:1785–1793CrossRefGoogle Scholar
- 22.Zis P, Tavernarakis A (2013) Headache and status epilepticus in the postpartum period; posterior reversible encephalopathy syndrome or cerebral venous thrombosis? Case Rep Emerg Med 2013:680327Google Scholar