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Volume 7 Issue 4 (April, 2019)

Original Articles

Prognostic Value and Usefulness of STESS Score in Refractory Status Epilepticus Patients
Amit Sharma, Parampreet Singh, Manoj K Goyal, Vivek Lal

Introduction: Status epilepticus (SE) is the most severe manifestation of epilepsy, which requires intensive care. Its incidence ranges from 15 to 20 per 100,000 per year and is 2nd most frequent emergency in neurology. Refractory status epilepticus (RSE) establishes in 23-43% section of the patients with SE. Aim: the study aimed to investigate the prognostic value of STESS score in RSE patients. Material and methods: This retrospective analysis of patients with RSE was conducted on 52 patients of RSE who were admitted in the Emergency Medical Department or Neurology ward, of our tertiary care hospital (Postgraduate Institute of Medical Education and Research, Chandigarh). RSE was diagnosed if a first line (either lorazepam or diazepam) and a second line drug (either of the following: phenytoin or levetiracetam). Demographic information, history of epilepsy and precipitating causes were noted. The severity of RSE was determined by the Status Epilepticus Severity Score (STESS).  Results: The mean age of patients at time of evaluation was 36.53± 15.81 (range: 13-70) years with male predominance. Risk factors for epilepsy like febrile seizure, neonatal seizure, congenital CNS malformation and perinatal distress were reported in the study sample. Status epilepticus severity score (STESS) was determined in all the patients. No patient had 0 score, 5 (9.61%) patients had 1 score, 15 (28.85%) had 2 score, 25 (48.08%) had 3 score, 6 (11.54%) patients had 4 score and 1 (1.92%) patient had 6 score (Table 1). STESS score is predictor of outcome of status epilepticus. Scores 0 to 2 are considered favourable; it was seen in 20 (38.46%) patients and unfavourable in 32 (61.54%) patients. Conclusion: Our results regarding the ability of STESS to predict mortality in patients with RSE are consistent with previous findings. Further prospective studies are necessary to analyze the role of baseline comorbidities and the capacity of such prognostic scales to predict long-term mortality and functional outcome in RSE.
Key Words: Status epilepticus, Refractory status epilepticus, Status Epilepticus Severity Score (STESS).

Received: 18 February, 2019                                     Revised: 28 March, 2019                         Accepted: 29 March, 2019

Corresponding author: Dr. Amit Sharma, Senior Resident, Department of Neurology, Post Graduate Institute of Medical Education & Research, Chandigarh, India

This article may be cited as: Sharma A, Singh P, Goyal MK, Lal V. Prognostic Value and Usefulness of STESS Score in Refractory Status Epilepticus Patients.  J Adv Med Dent Scie Res 2019;7(4): 121-124.

 
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