Etiological Profile of Status Epilepticus: A Hospital-based Prospective Observational Study from North Indian State of Uttarakhand
Background: Status epilepticus is encountered commonly in the emergency and maybe fatal if not treated adequately. An etiological evaluation is mandatory to prevent recurrence.
Objectives: Due to lack of data from the state of Uttarakhand, we wished to estimate the proportion of status epilepticus of all the patients with seizures and the underlying etiologies.
Methods: All patients over 18 years presenting with generalized seizures over 1 year were included after written informed consent and institutional ethical clearance. Diagnostic work-up was individualized to ascertain an etiology and included relevant hematological, biochemical and radiologic investigations.
Results: Seizures were the cause of hospitalization in 190 cases of which 26.3% (n=50) presented exclusively with convulsive status epilepticus. Mean age was 42.1 years with slight male predominance. Forty percent of these were known epileptics; only 25% were treatment compliant. Infectious diseases (50%) (neurocysticercosis, tuberculoma; tuberculous, rickettsial and viral meningo-encephalitis), cerebrovascular disease (22%) (arterial and venous) and metabolic disorders (10%) were the major causes of status epilepticus. Withdrawal of anti-epileptic drugs was implicated in 14% cases.
Conclusions: Infectious diseases remain the most important etiological group of status epilepticus in this part of the world. Non-adherence to anti-epileptic drug treatment is a potentially preventable cause, in isolation as well in combination with another co-morbidity.
Keywords: Status Epilepticus, ring-enhancing lesions, neurocysticercosis