Objective: To characterize the duration of seizures and inter-seizure intervals in focal status epilepticus (SE). Methods: We reviewed consecutive scalp EEG recordings from adult patients who were admitted for a first episode of focal status epilepticus. We identified electrographic seizure duration and inter-seizure intervals in the first diagnostic pretreatment EEG. We also reviewed isolated focal self-limiting seizures in epilepsy patients, as a comparison group for seizure duration. Results: We recorded 307 focal seizures in 100 consecutive focal SE episodes, with a median seizure duration of 107 s (IQR: 54–186), and 134 isolated focal self-limiting seizures in 42 epilepsy patients, with a median duration of 59 s (IQR: 30–90; p <.001). The only clinical feature of SE that significantly increased seizure duration was acute symptomatic etiology. In SE, 15% and 7% of seizures lasted longer than 300 and 600 s, respectively (t1 of the actual definition for tonic–clonic and focal SE), while only 1% of self-limiting seizures lasted longer than 300 s, and none lasted longer than 600 s. The analysis of inter-seizure intervals in SE with multiple seizures showed that 50% of the inter-seizure periods were shorter than 60 s, and 95% were shorter than 540 s (9 min). Patients who had an increase in seizure duration (last versus first) of at least 1.4 times showed an increased 30-day mortality. Significance: Focal seizures within a SE episode showed a wide range of duration, partly overlapping with the duration of focal self-limiting seizures but with a longer median duration. Inter-seizure intervals within an episode of SE were shorter than 1 min in 50% of the seizures and never lasted more than 10 min. Finally, an increase in seizure duration could represent an “electrophysiological biomarker” of a more severe SE episode, which may require more aggressive and rapid treatment.

Electrographic seizure duration and inter-seizure intervals in focal status epilepticus / Meletti, S.; Turchi, G.; Orlandi, N.; Vaudano, A. E.; Cioclu, M. C.; Pugnaghi, M.; Giovannini, G.. - In: EPILEPTIC DISORDERS. - ISSN 1294-9361. - 25:4(2023), pp. 519-527. [10.1002/epd2.20071]

Electrographic seizure duration and inter-seizure intervals in focal status epilepticus

Meletti S.;Vaudano A. E.;
2023

Abstract

Objective: To characterize the duration of seizures and inter-seizure intervals in focal status epilepticus (SE). Methods: We reviewed consecutive scalp EEG recordings from adult patients who were admitted for a first episode of focal status epilepticus. We identified electrographic seizure duration and inter-seizure intervals in the first diagnostic pretreatment EEG. We also reviewed isolated focal self-limiting seizures in epilepsy patients, as a comparison group for seizure duration. Results: We recorded 307 focal seizures in 100 consecutive focal SE episodes, with a median seizure duration of 107 s (IQR: 54–186), and 134 isolated focal self-limiting seizures in 42 epilepsy patients, with a median duration of 59 s (IQR: 30–90; p <.001). The only clinical feature of SE that significantly increased seizure duration was acute symptomatic etiology. In SE, 15% and 7% of seizures lasted longer than 300 and 600 s, respectively (t1 of the actual definition for tonic–clonic and focal SE), while only 1% of self-limiting seizures lasted longer than 300 s, and none lasted longer than 600 s. The analysis of inter-seizure intervals in SE with multiple seizures showed that 50% of the inter-seizure periods were shorter than 60 s, and 95% were shorter than 540 s (9 min). Patients who had an increase in seizure duration (last versus first) of at least 1.4 times showed an increased 30-day mortality. Significance: Focal seizures within a SE episode showed a wide range of duration, partly overlapping with the duration of focal self-limiting seizures but with a longer median duration. Inter-seizure intervals within an episode of SE were shorter than 1 min in 50% of the seizures and never lasted more than 10 min. Finally, an increase in seizure duration could represent an “electrophysiological biomarker” of a more severe SE episode, which may require more aggressive and rapid treatment.
2023
25
4
519
527
Electrographic seizure duration and inter-seizure intervals in focal status epilepticus / Meletti, S.; Turchi, G.; Orlandi, N.; Vaudano, A. E.; Cioclu, M. C.; Pugnaghi, M.; Giovannini, G.. - In: EPILEPTIC DISORDERS. - ISSN 1294-9361. - 25:4(2023), pp. 519-527. [10.1002/epd2.20071]
Meletti, S.; Turchi, G.; Orlandi, N.; Vaudano, A. E.; Cioclu, M. C.; Pugnaghi, M.; Giovannini, G.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1307046
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