dc.contributor.author
Reinecke, Lili C. S.
dc.contributor.author
Doerrfuss, Jakob I.
dc.contributor.author
Kowski, Alexander B.
dc.contributor.author
Holtkamp, Martin
dc.date.accessioned
2023-07-25T12:59:44Z
dc.date.available
2023-07-25T12:59:44Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/40240
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-39960
dc.description.abstract
Background: When treating patients with epileptic seizures in the emergency room (ER), it is of paramount importance to rapidly assess whether the seizure was acute symptomatic or unprovoked as the former points to a potentially life-threatening underlying condition. In this study, we seek to identify predictors and analyze characteristics of acute symptomatic seizures (ASS).
Methods: Data from patients presenting with seizures to highly frequented ERs of two sites of a university hospital were analyzed retrospectively. Seizures were classified as acute symptomatic or unprovoked according to definitions of the International League Against Epilepsy. Univariate and multivariate analysis were conducted to identify predictors; furthermore, characteristics of ASS were assessed.
Results: Finally, 695 patients were included, 24.5% presented with ASS. Variables independently associated with ASS comprised male sex (OR 3.173, 95% CI 1.972-5.104), no prior diagnosis of epilepsy (OR 11.235, 95% CI 7.195-17.537), and bilateral/generalized tonic-clonic seizure semiology (OR 2.982, 95% CI 1.172-7.588). Alcohol withdrawal was the most common cause of ASS (74.1%), with hemorrhagic stroke being the second most prevalent etiology. Neuroimaging was performed more often in patients with the final diagnosis of ASS than in those with unprovoked seizures (82.9% vs. 67.2%, p < 0.001). Patients with ASS were more likely to receive acute antiseizure medication in the ER (55.9% vs. 30.3%, p < 0.001).
Conclusions: In one quarter of patients presenting to the ER after an epileptic fit, the seizure had an acute symptomatic genesis. The independently associated variables may help to early identify ASS and initiate management of the underlying condition.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Alcohol withdrawal
en
dc.subject
Antiseizure medication
en
dc.subject
Unprovoked seizure
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Acute symptomatic seizures in the emergency room: predictors and characteristics
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s00415-021-10871-5
dcterms.bibliographicCitation.journaltitle
Journal of Neurology
dcterms.bibliographicCitation.number
5
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
2707
dcterms.bibliographicCitation.pageend
2714
dcterms.bibliographicCitation.volume
269
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.funding
Springer Nature DEAL
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
34727204
dcterms.isPartOf.issn
0340-5354
dcterms.isPartOf.eissn
1432-1459