What is the prognosis of status epilepticus (SE)?

Updated: Feb 13, 2018
  • Author: Julie L Roth, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Prognosis is related most strongly to the underlying process causing SE. For example, if meningitis is the etiology, the course of that disease dictates outcome. Patients with SE from anticonvulsant irregularity or those with alcohol-related seizures generally have a favorable prognosis if treatment is commenced rapidly and complications are prevented.

A multivariate analysis by Drislane et al identified presentation in coma and SE caused by anoxia/hypoxia as indicators of a poor prognosis. [39] However, in a small case series of cardiac arrest patients who developed postanoxic SE, predictors of a favorable outcome included preserved brainstem reactions, cortical somatosensory evoked potentials, and EEG reactivity. [40] These patients were treated with therapeutic hypothermia.

The more advanced the stage of SE, the less favorable the response to treatment. In the Veterans Affairs Status Epilepticus Cooperative study, 56% of patients who were first seen with overt, generalized convulsive SE responded to initial treatment. Only 15% of the individuals with subtle, generalized convulsive SE responded to initial treatment. [41] Treating nonconvulsive SE is urgent because longer duration of this condition correlates with a worse prognosis. [42]


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