Identify the effect of early appropriate treatment of status epilepticus on outcomes including duration of status epilepticus.

Overall mortality and morbidity associated with status epilepticus remains high. Prognostic factors previously identified for poor outcomes include time to initiation of treatment, appropriate dosing of treatment, duration of status, and etiology.

Using ICD-9/10 codes we retrospectively identified patients who were transferred to our tertiary medical center between January 2010 and January 2018, with the diagnosis of status epilepticus, as defined by the ILAE Task Force. Data collected included age, sex, history of epilepsy, medications administered acutely, duration of status epilepticus, occurrence of non-convulsive status epilepticus (NCSE), outcomes (disposition and mortality), etiology, among other clinical variables. Appropriate treatment was defined as early adequate doses of Benzodiazepines and Propofol.

154 patients were identified with status epilepticus. Appropriate identification and treatment were associated with status lasting < 24 hours (p 0.021, OR 2.06, CI 1.11-3.84) and less incidence of NCSE (p 0.001, OR 2.88, CI 1.53-5.42).  In a logistic regression model correcting for age, sex, and a history of epilepsy these findings persisted (p 0.035, OR 2.04, CI 1.5-3.99).  There did not seem to be any statistical association between appropriate treatment and the development of super-refractory status epilepticus or mortality.  A history of epilepsy prior to the episode of status was protective with status lasting less than 24 hours (p 0.003, OR 0.39, CI 0.21-0.74) and less incidence of non-convulsive status epilepticus (p 0.007, OR 0.42, CI 0.23-0.8). Severn of the 20 patients who expired developed super-refractory status epilepticus (35%).

Appropriate treatment at presentation with status epilepticus affects the duration of status epilepticus and the development of non-convulsive status epilepticus but may not be associated with mortality