[Prognosis in status epilepticus]

Abstract

Status epilepticus (SE), an special epileptic syndrome, is a frequent neurological emergency (50/100,000) and a critical condition (mean mortality 22%, in 3% of pediatric patients and 38% in the elderly). Accepting its widest concept, it appears without history of epilepsy in 58%. Neuronal damage, mainly hypocampal, has been experimentally demonstrated in convulsive and nonconvulsive SE. We attempt to demonstrate that the most important prognostic factors are: age, more related to morbidity in children and in mortality in the elderly; etiology, determining the evolution in most cases, but not always: in the same etiological group, the coincidence of SE can increase threefold the mortality; the seizure type, especially the convulsive SE; patients with previous epilepsy have a better outcome; the epileptic syndrome, rather determinant of incidence and outcome of the SE in the childhood; the length of SE, but in the cases of outcome directly depending on the etiology; the evolutive phase in which treatment is started; the complications, mainly respiratory; the global therapeutical strategy and the adequate use of drugs, related to order, dosage and timing, are determinant of morbidity and mortality.