What is the mortality associated with 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

Mortality rates related to SE have decreased over the last 60 years, probably in relation to faster diagnosis and more aggressive treatment. The probability of death is closely correlated with age. In prospective population-based studies, DeLorenzo et al found mortality rates of 13% for young adults, 38% for the elderly, and >50% for those older than 80 years. [34]

In 1998, the Veterans Affairs Status Epilepticus Cooperative Study Group reported mortality rates of 27% for overt generalized convulsive SE and 65% for subtle generalized convulsive SE. [41] DeLorenzo et al reported a mortality rate of 21% in patients with generalized SE, defining mortality as death occurring within 30 days. [32]

Aicardi and Chevrie examined 239 children with generalized convulsive SE that lasted longer than an hour; 26 died, and 88 had permanent neurologic damage (47 of whom had been neurologically intact before the episode). [43]

Death most often is related to an underlying cause of brain injury. [44] According to Hauser, no more than 2% of patients die directly from SE. [45]

In a prospective study of 24 SE patients who died, 10 had a gradual decrease in mean arterial pressure and/or heart rate. The remaining 14 had no cardiac changes until the time of death. About 90% of patients with cardiac decompensation had a history of many risk factors for atherosclerotic cardiovascular disease, whereas only 30% of those without acute cardiac decompensation had clinically significant risk factors. [46]


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