Stroke and Non Convulsive Status Epilepticus. A Topographic and Prognosis Description. (P5.112)

Objective: To analyze the relationship between acute stroke and NCSE, complication that could negatively impact on the patient’s outcome. Background: Non-convulsive status epilepticus (NCSE) is a rare complication of acute Stroke (0.2 -1%). NCSE in the context of an acute stroke is associated with poor prognosis and may even cause death. Few reports relate the topography of stroke with NCSE, and none of them analyze the relationship with refractory NCSE. (rNCSE ). Design and methods: We retrospectively analyzed the medical records of patients admitted between January/2007 and November/2011 with stroke who developed NCSE during the hospitalization. We considered the following variables: topography, extension, causes, and mortality. These were analyzed both in the rNCSE and NCSE population. Exclusion criteria were TIA, previous stroke or history of epilepsy of any type. Results: 354 stroke patients, 14 (4 women) developed NCSE, 5 of them were rNCSE. In-hospital mortality was 21 %. 60 % were located in the right hemisphere and 17 % were bilateral. 65% were cortico-subcortical lesions. Frontal lobe was involved in 100% of cases. rNCSE was more frequently present in lesion involving more than two lobes (60 %). Regarding the aetiology, 35% were periprocedural, 14 % cardioembolic, and 14% large vessel disease. 100% of patients who died had received cefepime. Conclusions: Even though this is a preliminary study, NCSE seems to be a serious complication with a high impact on the prognosis of acute stroke. The association between stroke and NCSE appears to be more frequent in men, right hemisphere localization, and curiously, our population involved the frontal lobe in 100% of the cases. Stroke in the anterior cerebral artery territory and exposure to cefepime suggested a lack of initial response to antiepileptic treatment with higher mortality. Recognizing these variables may be useful to define more aggressive antiepileptic treatments in this population. Disclosure: Dr. Munoz has nothing to disclose. Dr. Calle has received personal compensation for activities with UCB Pharma. Dr. Gonzalez Toledo has nothing to disclose. Dr. Pagani Cassara has nothing to disclose. Dr. Tamargo has nothing to disclose. Dr. Thomson has nothing to disclose. Dr. Nadile has nothing to disclose. Dr. Klein has nothing to disclose.