Profile of status epilepticus : a prospective study.

Forty adult patients (age >14 years) of generalised convulsive status epilepticus were studied prospectively. All the patients were subjected to detailed history, neurological examination and baseline investigations including haemogram and metabolicprofile. CT scan was carried out in 26 patients. All the patients were treated with intravenous diazepam and phenytoin. The age range of the patients was 14-71 years with a mean of 32.75 ? 15.78. There were 24 males and 16 females. Twenty six patients had generalised tonic clonic seizures while 14 had partial seizures with secondary generalisation. Symptomatic epilepsy was the commonest type of epilepsy and was seen in 25 patients. The diagnosis of cryptogenic and idiopathic epilepsies was made in 11 and 4 patients respectively. Drug withdrawl precipitated status epilepticus in 5 patients and systemic infection in one. The mean frequency of seizures was 4.70??1.83/hour, mean duration was 1.78???l.0l/minutes and cumulative convulsive time 25.27??21.50 minutes. Twelve patients had focal neurologic deficits. Papilloedema was seen in four cases only. CT scan was abnormal in 18 of 26 patients. All patients except one showed immediate response to therapy. Seven patients had recurrence of seizures after initial response to diazepam and phenytoin. Low serum level of the drug at 12 hours had a significant correlation with recurrence of seizures. Ataxia was the most common side effect of phenytoin therapy. Serious side effects e.g. hypotension and respiratory depression were seen in 4 and 2 patients respectively. Two patients expired during 48 hours follow up.