PMID- 34244997
OWN - NLM
STAT- MEDLINE
DCOM- 20220303
LR  - 20220303
IS  - 1528-1167 (Electronic)
IS  - 0013-9580 (Print)
IS  - 0013-9580 (Linking)
VI  - 62
IP  - 9
DP  - 2021 Sep
TI  - Clinical phenotypes within nonconvulsive status epilepticus.
PG  - e129-e134
LID - 10.1111/epi.16999 [doi]
AB  - The study aimed to identify distinct phenotypes within nonconvulsive status 
      epilepticus (NCSE). Consecutive episodes of NCSE in patients at least 14 years 
      old were included. The level of consciousness was assessed through the Glasgow 
      Coma Scale (GCS). Etiology of NCSE was defined as symptomatic (acute, remote, 
      progressive) or unknown. Electroencephalographic (EEG) recordings were searched 
      for lateralized periodic discharges (LPDs), generalized sharply and/or triphasic 
      periodic potentials (GPDs), and spontaneous burst suppression (BS). According to 
      treatment response, NCSE was classified as responsive, refractory, or 
      superrefractory. Average linkage hierarchical cluster analysis was performed with 
      Pearson correlation as similarity measure. Two hundred twenty-nine episodes of 
      NCSE were included. Three clusters were identified. The first cluster linked GCS 
      score 3-8, presence of spontaneous BS on EEG, acute symptomatic etiology, and 
      treatment superrefractoriness. The second cluster gathered GCS score 9-12, 
      presence of LPDs or GPDs on EEG, unknown etiology, and treatment refractoriness. 
      The third cluster associated GCS score 13-15, absence of LPDs, GPDs, and 
      spontaneous BS on EEG, and progressive and remote symptomatic etiology with 
      treatment responsiveness. Phenotyping the heterogeneity of NCSE into 
      electroclinical clusters can contribute to understanding correlations between 
      pathologic and clinical domains, assessing the intrinsic severity of NCSE 
      episodes, and estimating the likelihood of treatment responsiveness.
CI  - (c) 2021 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of 
      International League Against Epilepsy.
FAU - Lattanzi, Simona
AU  - Lattanzi S
AUID- ORCID: 0000-0001-8748-0083
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Ancona, Italy.
FAU - Giovannini, Giada
AU  - Giovannini G
AUID- ORCID: 0000-0002-3585-5872
AD  - Neurology Unit, Baggiovara Civil Hospital, AOU Modena, Modena, Italy.
AD  - PhD Program in Clinical and Experimental Medicine, University of Modena and 
      Reggio Emilia, Modena, Italy.
FAU - Brigo, Francesco
AU  - Brigo F
AUID- ORCID: 0000-0003-0928-1577
AD  - Department of Neuroscience, Biomedicine, and Movement Science, University of 
      Verona, Verona, Italy.
AD  - Division of Neurology, Franz Tappeiner Hospital, Merano, Italy.
FAU - Orlandi, Niccolo
AU  - Orlandi N
AUID- ORCID: 0000-0002-5717-7363
AD  - Neurology Unit, Baggiovara Civil Hospital, AOU Modena, Modena, Italy.
AD  - Department of Biomedical, Metabolic, and Neural Science, Center for Neuroscience 
      and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy.
FAU - Trinka, Eugen
AU  - Trinka E
AUID- ORCID: 0000-0002-5950-2692
AD  - Department of Neurology, Christian Doppler Clinic, Paracelsus Medical University, 
      Salzburg, Austria.
AD  - Center for Cognitive Neuroscience, Salzburg, Austria.
AD  - Public Health, Health Services Research and HTA, University for Health Sciences, 
      Medical Informatics and Technology, Hall in Tirol, Austria.
FAU - Meletti, Stefano
AU  - Meletti S
AUID- ORCID: 0000-0003-0334-539X
AD  - Neurology Unit, Baggiovara Civil Hospital, AOU Modena, Modena, Italy.
AD  - Department of Biomedical, Metabolic, and Neural Science, Center for Neuroscience 
      and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210709
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
SB  - IM
MH  - Adolescent
MH  - Coma
MH  - Electroencephalography
MH  - Glasgow Coma Scale
MH  - Humans
MH  - Phenotype
MH  - *Status Epilepticus/diagnosis
PMC - PMC8456934
OTO - NOTNLM
OT  - hierarchical cluster analysis
OT  - phenotypes
OT  - status epilepticus
COIS- S.L. has received speaker's or consultancy fees from Eisai, GW Pharmaceuticals, 
      and UCB Pharma and has served on advisory boards for Angelini Pharma, Arvelle 
      Therapeutics, BIAL, and GW Pharmaceuticals. F.B. has acted as a consultant for 
      Eisai. E.T. has received speaker's honoraria from UCB, Biogen, Gerot-Lannach, 
      BIAL, Eisai, Takeda, Newbridge, Sunovion Pharmaceuticals, LivaNova, and Novartis; 
      consultancy funds from UCB, Biogen, Gerot-Lannach, BIAL, Eisai, Takeda, 
      Newbridge, GW Pharmaceuticals, Sunovion Pharmaceuticals, and Novartis; and 
      directorship funds from Neuroconsult. E.T.'s institution has received grants from 
      Biogen, Red Bull, Merck, UCB, the European Union, FWF Osterreichischer Fond zur 
      Wissenschaftsforderung, and Bundesministerium fur Wissenschaft und Forschung. 
      S.M. has received research grant support from the Ministry of Health and from the 
      nonprofit organization Fondazione Cassa di Risparmio di Modena and has received 
      personal compensation as a scientific advisory board member for UCB and EISAI. 
      Neither of the other authors has any conflict of interest to disclose. We confirm 
      that we have read the Journal's position on issues involved in ethical 
      publication and affirm that this report is consistent with those guidelines.
EDAT- 2021/07/11 06:00
MHDA- 2022/03/04 06:00
PMCR- 2021/09/22
CRDT- 2021/07/10 06:28
PHST- 2021/06/24 00:00 [revised]
PHST- 2021/04/03 00:00 [received]
PHST- 2021/06/25 00:00 [accepted]
PHST- 2021/07/11 06:00 [pubmed]
PHST- 2022/03/04 06:00 [medline]
PHST- 2021/07/10 06:28 [entrez]
PHST- 2021/09/22 00:00 [pmc-release]
AID - EPI16999 [pii]
AID - 10.1111/epi.16999 [doi]
PST - ppublish
SO  - Epilepsia. 2021 Sep;62(9):e129-e134. doi: 10.1111/epi.16999. Epub 2021 Jul 9.