Results A total of 132 CSE patients was included, with a median age of 25.5 years and 60.6% were male. Three months post discharge, an unfavorable outcome with mRS of 3–6 was seen in 62 (47.0%) patients, 25 (18.9%) of whom died. Logistic regression analysis revealed that encephalitis ( p = 0.029), nonconvulsive SE ( p = 0.018), diazepam resistance ( p = 0.005), image abnormalities (unilateral lesions, p = 0.027; bilateral lesions or diffuse cerebral edema, p. Convulsive status epilepticus (CSE) is a common, life-threatening neurological disorder [ ].

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Status epileptikus ini sendiri didefinisikan sebagai kondisi bangkitan yang berlangsung lebih dari 30 menit, atau adanya dua bangkitan atau lebih di mana di antara bangkitan-bangkitan tadi tidak terdapat pemulihan kesadaran. We discuss a protocol being followed at AIIMS for the management of status epilepticus based on review of available evidence.Definition Status epilepticus has been defined as continuous seizure activity lasting more than 30 min or 2 or more seizures in this duration without gaining consciousness between them [1].

Even with prompt treatment, the mortality rate remains high, ranging from 7.6 to 39% [ ], and more than 10% of survivors develop neurological and cognitive disabilities [, ]. An accurate quantification of CSE severity and a reliable predictor of functional outcomes would be beneficial for clinicians in optimizing individualized patient management and communicating with relatives and other healthcare professionals. Currently, two scores for SE outcome prediction are available, the Status Epilepticus Severity Score (STESS) [, ] and the Epidemiology based Mortality score in SE (EMSE) [ ]. The STESS was developed from a retrospective study and was based on four variables at the time of presentation: history of seizures, age, seizure type, and consciousness impairment [ ]. The EMSE score was derived from a retrospective, exploratory analysis based on epidemiological data and taking into consideration etiology, age, comorbidity and electroencephalogram (EEG) data [ ].

Both of these scores have been primarily used to predict survival vs. Death in the hospital setting. However, no scoring system currently exists for the purpose of predicting the functional outcome of patients with CSE once they have been discharged. Here we performed a retrospective cohort study, on the basis of a prospective registry for SE, with two aims: (1) to identify independent prognostic factors associated with the functional outcome of patients three months after discharge from the hospital setting by analyzing demographic data, clinical features, neuroimages, and the treatment of the disease in the hospital; and (2) to establish a prognostic score by incorporating these variables according to their determined relative contributions to the resulting functional outcome.

Study setting and patients This retrospective analysis utilized a registry for SE from the neurological intensive care unit (N-ICU) at Xijing Hospital, a tertiary academic medical care institution with 3200-beds in Xi’an, China. All patients with CSE from March 2008 to November 2014 were recruited for this study as long as they were older than 12 years of age. CSE was defined as 30 minutes or more of (1) continuous motor seizure activity or (2) recurrent seizure activity without regaining full consciousness between episodes [ ]. Subjects with CSE from cerebral anoxia were excluded due to the high rate of mortality [ ]. All patients were followed up for at least three months after discharge from Xijing Hospital. For this, two to three telephone numbers (both mobile and landline) were collected from the patients’ relatives at the time of registry.

The present study was approved by the ethics committee of the Xijing Hospital and was carried out in agreement with Chinese laws and the Helsinki declaration relative to patients’ rights. SE treatment procedure All of the CSE patients were treated according to the established hospital protocol, which was based upon published guideline recommendations [, ]. Intravenous (IV) diazepam was administered as a first-line antiepileptic drug (AED), followed by IV second-line AEDs if SE persisted (e.g., valproic acid, phenobarbital).