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. 2024 Feb 22;10(5):e26833.
doi: 10.1016/j.heliyon.2024.e26833. eCollection 2024 Mar 15.

Factors affecting seizure recurrence in the emergency department

Umit Can Dolek  1   2 , Mustafa Gokce  3 , Mehmet Muzaffer Islam  2 , Serdar Ozdemir  2 , Gokhan Aksel  2 , Abdullah Algin  2
Affiliations

Factors affecting seizure recurrence in the emergency department

Umit Can Dolek et al. Heliyon. .

Abstract

Background: Information on Emergency Department (ED) follow-up of patients presenting with epileptic seizures is limited.

Objectives: It was planned to investigate the factors affecting the recurrence of epileptic seizures in the follow-up of patients presenting to the ED with the complaint of epileptic seizures.

Materials and methods: This prospective, observational, single-center study was carried out in an adult population presenting to the ED. The study included patients older than 18 years of age presenting to the ED with the complaint of epileptic seizures.

Results: Of the 205 patients included in the study, 68 (33.2%) had seizure recurrence during the 6 h. In the univariable analysis, advanced age, prolonged post-ictal duration, increased seizure duration, generalized tonic clonic seizure, alcohol consumption within past 24 h, hypertension, coronary artery disease, Alzheimer's disease, prior ischemic cerebrovascular disease, low Glascow Coma Scale (GCS), high glucose, high C-Reactive Protein, high phosphorus, low potassium, high blood urea nitrogen, high lactate, increased anion gap, high osmolarity were statistically significant in predicting recurrent seizure recurrence within 6 h. According to the logistic regression, postictal duration, GCS score, and age were independent predictors in our model. The cut-off value of postictal duration in predicting seizure recurrence at the highest sensitivity (66.2%) and specificity (89.8%) was 22.5 min.

Conclusion: A prolonged postictal state, low GCS score, advanced age may be an indication of seizure recurrence. Therefore, patients with a long postictal duration, low GCS score, advanced age should be followed up more carefully in terms of recurrent seizures in the ED.

Keywords: Epilepsy cluster; Immediate seizure; Recurrent epilepsy; Recurrent seizure.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Patient flow chart.
Fig. 2
Fig. 2
Receiver operating characteristic curve of postictal duration in predicting seizure recurrence within 6 h.
See this image and copyright information in PMC

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