PMID- 29574298
OWN - NLM
STAT- MEDLINE
DCOM- 20190221
LR  - 20190221
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 82
DP  - 2018 May
TI  - The relevance of timing in nonconvulsive status epilepticus: A series of 38 
      cases.
PG  - 11-16
LID - S1525-5050(18)30069-6 [pii]
LID - 10.1016/j.yebeh.2018.02.029 [doi]
AB  - BACKGROUND: Timing in the management of nonconvulsive status epilepticus (NCSE) 
      seems to be one of the most important modifiable prognostic factors. We aimed to 
      determine the precise relationship between timing in NCSE management and its 
      outcome. METHODS: We performed a cross-sectional study in which clinical data 
      were prospectively obtained from all consecutive adults with NCSE admitted to our 
      hospital from 2014 to 2016. Univariate and multivariable regression analyses were 
      performed to identify clinical and timing variables associated with NCSE 
      prognosis. RESULTS: Among 38 NCSE cases, 59.9% were women, and 39.5% had prior 
      epilepsy history. The median time to treatment (TTT) initiation and the median 
      time to assessment by a neurologist (TTN) were 5h, and the median time to first 
      electroencephalography assessment was 18.5h; in the cases with out-of-hospital 
      onset (n=24), the median time to hospital (TTH) arrival was 2.8h. The median time 
      to NCSE control (TTC) was 16.5h, and it positively correlated with both the TTH 
      (Spearman's rho: 0.439) and the TTT (Spearman's rho: 0.683). In the multivariable 
      regression analyses, the TTC was extended 1.7h for each hour of hospital arrival 
      delay (p=0.01) and 2.7h for each hour of treatment delay (p<0.001). Recognition 
      delay was more common in the episodes with in-hospital onset, which also had 
      longer TTN and TTC, and increased morbidity. CONCLUSIONS: There were pervasive 
      delays in all phases of NCSE management. Delays in hospital arrival or treatment 
      initiation may result in prolonged TTC. Recognition of in-hospital episodes may 
      be more delayed, which may lead to poorer prognosis in these cases.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Gutierrez-Viedma, Alvaro
AU  - Gutierrez-Viedma A
AD  - Unidad de Epilepsia, Servicio de Neurologia, Hospital Clinico San Carlos, Calle 
      Profesor Martin Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, 
      Facultad de Medicina, Universidad Complutense de Madrid, Avenida Seneca 2, 28040 
      Madrid, Spain; Instituto de Investigacion Sanitaria del Hospital Clinico San 
      Carlos (IdISSC), Calle Profesor Martin Lagos s/n, 28040 Madrid, Spain. Electronic 
      address: alvgut05@ucm.es.
FAU - Parejo-Carbonell, Beatriz
AU  - Parejo-Carbonell B
AD  - Unidad de Epilepsia, Servicio de Neurologia, Hospital Clinico San Carlos, Calle 
      Profesor Martin Lagos s/n, 28040 Madrid, Spain; Instituto de Investigacion 
      Sanitaria del Hospital Clinico San Carlos (IdISSC), Calle Profesor Martin Lagos 
      s/n, 28040 Madrid, Spain. Electronic address: 
      fibinternacional.hcsc@salud.madrid.org.
FAU - Cuadrado, Maria-Luz
AU  - Cuadrado ML
AD  - Unidad de Epilepsia, Servicio de Neurologia, Hospital Clinico San Carlos, Calle 
      Profesor Martin Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, 
      Facultad de Medicina, Universidad Complutense de Madrid, Avenida Seneca 2, 28040 
      Madrid, Spain; Instituto de Investigacion Sanitaria del Hospital Clinico San 
      Carlos (IdISSC), Calle Profesor Martin Lagos s/n, 28040 Madrid, Spain. Electronic 
      address: mlcuadrado@med.ucm.es.
FAU - Serrano-Garcia, Irene
AU  - Serrano-Garcia I
AD  - Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), 
      Calle Profesor Martin Lagos s/n, 28040 Madrid, Spain; Unidad de Metodologia de 
      Investigacion y Epidemiologia Clinica, Servicio de Medicina Preventiva, Hospital 
      Clinico San Carlos, Calle Profesor Martin Lagos s/n, 28040 Madrid, Spain.
FAU - Abarrategui, Belen
AU  - Abarrategui B
AD  - Unidad de Epilepsia, Servicio de Neurologia, Hospital Clinico San Carlos, Calle 
      Profesor Martin Lagos s/n, 28040 Madrid, Spain; Instituto de Investigacion 
      Sanitaria del Hospital Clinico San Carlos (IdISSC), Calle Profesor Martin Lagos 
      s/n, 28040 Madrid, Spain.
FAU - Garcia-Morales, Irene
AU  - Garcia-Morales I
AD  - Unidad de Epilepsia, Servicio de Neurologia, Hospital Clinico San Carlos, Calle 
      Profesor Martin Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, 
      Facultad de Medicina, Universidad Complutense de Madrid, Avenida Seneca 2, 28040 
      Madrid, Spain; Instituto de Investigacion Sanitaria del Hospital Clinico San 
      Carlos (IdISSC), Calle Profesor Martin Lagos s/n, 28040 Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180322
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Electroencephalography/trends
MH  - Female
MH  - Hospitalization/*trends
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neurologists/trends
MH  - Prospective Studies
MH  - Status Epilepticus/*diagnosis/physiopathology/*therapy
MH  - Time Factors
MH  - Time-to-Treatment/*trends
OTO - NOTNLM
OT  - Epilepsy
OT  - In-hospital
OT  - Nonconvulsive status epilepticus
OT  - Out-of-hospital
OT  - Seizure duration
OT  - Treatment
EDAT- 2018/03/27 06:00
MHDA- 2019/02/23 06:00
CRDT- 2018/03/26 06:00
PHST- 2018/01/23 00:00 [received]
PHST- 2018/02/24 00:00 [revised]
PHST- 2018/02/27 00:00 [accepted]
PHST- 2018/03/27 06:00 [pubmed]
PHST- 2019/02/23 06:00 [medline]
PHST- 2018/03/26 06:00 [entrez]
AID - S1525-5050(18)30069-6 [pii]
AID - 10.1016/j.yebeh.2018.02.029 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2018 May;82:11-16. doi: 10.1016/j.yebeh.2018.02.029. Epub 2018 
      Mar 22.