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Clinical characteristics of non‐convulsive status epilepticus diagnosed by simplified continuous electroencephalogram monitoring at an emergency intensive care unit

机译:在急诊重症监护病房通过简化的连续脑电图监测诊断为非惊厥性癫痫持续状态的临床特征

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Aim The present study aimed to elucidate the clinical characteristics of non‐convulsive status epilepticus ( NCSE ) in patients with altered mental status ( AMS ). Methods This single‐center retrospective study comprised 149 patients who were hospitalized between March 1, 2015 and September 30, 2015 at the emergency intensive care unit ( ICU ) of the Kagawa University Hospital (Kagawa, Japan). The primary outcome was NCSE incidence. The secondary outcome was the comparison of duration of ICU stay, hospital stay, and a favorable neurological outcome, as assessed using the modified Rankin Scale score, at discharge from our hospital between patients with and without NCSE . Favorable neurological outcome and poor neurological outcome were defined as modified Rankin Scale scores of 0–2 and 3–6, respectively. Results Simplified continuous electroencephalogram was used to monitor 36 patients (median age, 68 years; 69.4% males) with acute AMS ; among them, NCSE was observed in 11 (30.1%) patients. Rates of favorable neurological outcome, duration of ICU stay, and hospital stay were not significantly different between the NCSE and non‐ NCSE groups (P = 0.45, P = 0.30, and P = 0.26, respectively). Conclusion Approximately 30% of the patients with AMS admitted to emergency ICU s developed NCSE . The outcomes of AMS patients with and without NCSE did not differ significantly when appropriate medical attention and antiepileptic drugs were initiated. Simplified continuous electroencephalogram monitoring may be recommended in patients with AMS in emergency ICU to obtain early detection of NCSE followed by appropriate intervention.
机译:目的本研究旨在阐明精神状态改变(AMS)患者的非惊厥性癫痫持续状态(NCSE)的临床特征。方法这项单中心回顾性研究包括149例患者,这些患者于2015年3月1日至2015年9月30日在日本香川大学医院急诊重症监护病房(ICU)住院。主要结局为NCSE发生率。次要结果是使用改良的Rankin量表评分评估的,有和没有NCSE的患者出院时ICU住院时间,住院时间和良好的神经系统结果的比较。神经病学预后良好和神经病学预后不良分别定义为改良的兰金量表评分为0–2和3–6。结果采用简化的连续脑电图监测36例急性AMS患者(中位年龄68岁;男性占69.4%)。其中,有11例(30.1%)患者被观察到NCSE。 NCSE组和非NCSE组之间的神经学预后良好率,ICU住院时间和住院时间均无显着差异(分别为 P = 0.45, P = 0.30和 P = 0.26 )。结论急诊ICU入院的AMS患者中约有30%患有NCSE。当开始适当的医疗护理和使用抗癫痫药时,患有和不患有NCSE的AMS患者的预后没有显着差异。对于急诊重症监护病房中的AMS患者,建议进行连续的简化脑电图监测,以尽早发现NCSE,然后进行适当干预。

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