Abstract Details

Title Clinical Features and Outcomes of Patients with Status Epilepticus Caused by Neuroinflammation

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-019

Objective To clarify the clinical features and outcomes in patients with status epilepticus (SE) associated with neuroinflammation, compared to those with non-neuroinflammatory etiologies.

Background Neuroinflammatory epilepsy, including autoantibody-related encephalitis, and its associated clinical demographics and outcomes, are areas of increasing medical focus and inquiry. However, the relevance of etiology and severity are poorly elucidated in this population.

Design/Methods This was a retrospective analysis of a prospective registry of adult patients with epilepsy, including those who presented with acute symptomatic attacks, who were hospitalized in our department from August 2010 to August 2018. We identified patients with SE, and classified them according to 2 etiological categories: neuroinflammatory (mostly associated with autoimmune or infectious encephalitis) and non-neuroinflammatory (mostly post-stroke). We then carried out between-group comparisons of the groups’ characteristics and outcomes. Statistical significance was analyzed with Fisher’s exact test.

Results Among the 169 consecutive patients hospitalized for epileptic attack, 77 patients with SE (28 neuroinflammatory, 49 non-neuroinflammatory etiology) were enrolled. There were no significant difference in clinical characteristics, including age, sex, and prevalence of previous seizures and non-convulsive SEs, between the groups. The positive percentage of focal abnormalities on electroencephalogram, increases in CSF protein levels in CSF, and abnormal findings on brain CT/MRI also did not differ between-groups. However, in the neuroinflammatory group, SE severity was significantly greater (84 vs 52% in the ratio of status epilepticus severity scale ≥3, p = 0.003). Patients with neuroinflammatory SE were more refractory to initial antiepileptic treatments (50% vs 24%, p = 0.027), and exhibited significantly more functional disabilities at discharge (48 vs 82% patients return to baseline, p = 0.002, and 44 vs 15% newly handicapped, p = 0.012).

Conclusions A diagnosis of neuroinflammatory SE potentially predicts refractory response to initial antiepileptic treatments and the presence of residual functional disabilities at discharge.

Authors/Disclosures
Makoto Hara, MD (Nihon University School of Medicine) PRESENTER	Dr. Hara has nothing to disclose.
Hideto Nakajima, MD (Seikeikai Hospital)	No disclosure on file
Tomotaka Mizoguchi	Tomotaka Mizoguchi has nothing to disclose.
	No disclosure on file
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