Non-Convulsive Status Epilepticus in Comatose Patients. (P4.247)

Objective: To describe a population of comatose patients with NCSE, analyze their prognosis and their EEG manifestations. Background: The diagnosis of non-convulsive status epilepticus (NCSE) in comatose patients can be challenging. It is common to find electric abnormalities in these patients, and it is not clear if they are the cause of the comatose state, or an epiphenomenon associated to brain injury. There is no consensus regarding how aggressive the treatment should be. Design and methods: We carried out a retrospective analysis of medical records of patients admitted to Favaloro Foundation University Hospital with NCSE between April/2007 and June/2013. We considered two groups of patients: those in a comatose state (NCSE- Coma) and those without (NCSE NOcoma). We compared the prognosis, mortality, clinical and electrical evolution. We analyzed time until diagnosis, time until electric control, number of drugs used and response to treatment. Results: We analyzed 112 NCSE. 55% women. Mean age was 68-years old (28-93). 31% belonged to the NCSE-coma group. There were no statistically significant differences between age and sex. Global mortality was 29%. The mortality in the NCSE-coma group was 43%; 23% in NCSE-NOcoma (p=0,036). There were no differences regarding time until diagnosis, time until NCSE control and number of drugs used. We found more refractory NCSE in the NCSE-Coma group compared to the NCSE-NOcoma group (p=0.042). The positive electrical outcome didn’t differ significantly, but clinical outcome did. This was associated to the NCSE-NOcoma group (p<0.001). The EEG patter in both groups was generalized in 85% of the cases. Conclusions: NCSE in comatose patients is associated to a higher mortality, depending on the etiology. Its appropriate treatment is not always associated to a good prognosis, indicating that coma can be a clinical manifestation of severe brain injury, and the possible cause of NCSE. Disclosure: Dr. Thomson has nothing to disclose. Dr. Calle has received personal compensation for activities with UCB Pharma. Dr. Tamargo has nothing to disclose. Dr. Gonzalez Toledo has nothing to disclose. Dr. Pagani Cassara has nothing to disclose. Dr. Nadile has nothing to disclose. Dr. Sinay has nothing to disclose. Dr. Thomson has nothing to disclose.