Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus

Purpose. Status epilepticus (SE) is an important neurological emergency. Early diagnosis could improve outcomes. Traditionally, SE is defined as seizures lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness. Some specialists argued that the duration of seizures...

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Main Authors: Cheung-Ter Ong, Yi-Sin Wong, Sheng-Feng Sung, Chi-Shun Wu, Yung-Chu Hsu, Yu-Hsiang Su, Ling-Chien Hung
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2015/801834
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author Cheung-Ter Ong
Yi-Sin Wong
Sheng-Feng Sung
Chi-Shun Wu
Yung-Chu Hsu
Yu-Hsiang Su
Ling-Chien Hung
author_facet Cheung-Ter Ong
Yi-Sin Wong
Sheng-Feng Sung
Chi-Shun Wu
Yung-Chu Hsu
Yu-Hsiang Su
Ling-Chien Hung
author_sort Cheung-Ter Ong
collection DOAJ
description Purpose. Status epilepticus (SE) is an important neurological emergency. Early diagnosis could improve outcomes. Traditionally, SE is defined as seizures lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness. Some specialists argued that the duration of seizures qualifying as SE should be shorter and the operational definition of SE was suggested. It is unclear whether physicians follow the operational definition. The objective of this study was to investigate whether the incidence of SE was underestimated and to investigate the underestimate rate. Methods. This retrospective study evaluates the difference in diagnosis of SE between operational definition and traditional definition of status epilepticus. Between July 1, 2012, and June 30, 2014, patients discharged with ICD-9 codes for epilepsy (345.X) in Chia-Yi Christian Hospital were included in the study. A seizure lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness were considered SE according to the traditional definition of SE (TDSE). A seizure lasting between 5 and 30 min was considered SE according to the operational definition of SE (ODSE); it was defined as underestimated status epilepticus (UESE). Results. During a 2-year period, there were 256 episodes of seizures requiring hospital admission. Among the 256 episodes, 99 episodes lasted longer than 5 min, out of which 61 (61.6%) episodes persisted over 30 min (TDSE) and 38 (38.4%) episodes continued between 5 and 30 min (UESE). In the 38 episodes of seizure lasting 5 to 30 minutes, only one episode was previously discharged as SE (ICD-9-CM 345.3). Conclusion. We underestimated 37.4% of SE. Continuing education regarding the diagnosis and treatment of epilepsy is important for physicians.
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spelling doaj-art-6b6975f565154a36949b4d16dca7a3472025-08-20T02:23:57ZengWileyThe Scientific World Journal2356-61401537-744X2015-01-01201510.1155/2015/801834801834Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status EpilepticusCheung-Ter Ong0Yi-Sin Wong1Sheng-Feng Sung2Chi-Shun Wu3Yung-Chu Hsu4Yu-Hsiang Su5Ling-Chien Hung6Department of Neurology, Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Family Medicine, Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Neurology, Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Neurology, Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Neurology, Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Neurology, Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Neurology, Chia-Yi Christian Hospital, Chiayi, TaiwanPurpose. Status epilepticus (SE) is an important neurological emergency. Early diagnosis could improve outcomes. Traditionally, SE is defined as seizures lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness. Some specialists argued that the duration of seizures qualifying as SE should be shorter and the operational definition of SE was suggested. It is unclear whether physicians follow the operational definition. The objective of this study was to investigate whether the incidence of SE was underestimated and to investigate the underestimate rate. Methods. This retrospective study evaluates the difference in diagnosis of SE between operational definition and traditional definition of status epilepticus. Between July 1, 2012, and June 30, 2014, patients discharged with ICD-9 codes for epilepsy (345.X) in Chia-Yi Christian Hospital were included in the study. A seizure lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness were considered SE according to the traditional definition of SE (TDSE). A seizure lasting between 5 and 30 min was considered SE according to the operational definition of SE (ODSE); it was defined as underestimated status epilepticus (UESE). Results. During a 2-year period, there were 256 episodes of seizures requiring hospital admission. Among the 256 episodes, 99 episodes lasted longer than 5 min, out of which 61 (61.6%) episodes persisted over 30 min (TDSE) and 38 (38.4%) episodes continued between 5 and 30 min (UESE). In the 38 episodes of seizure lasting 5 to 30 minutes, only one episode was previously discharged as SE (ICD-9-CM 345.3). Conclusion. We underestimated 37.4% of SE. Continuing education regarding the diagnosis and treatment of epilepsy is important for physicians.http://dx.doi.org/10.1155/2015/801834
spellingShingle Cheung-Ter Ong
Yi-Sin Wong
Sheng-Feng Sung
Chi-Shun Wu
Yung-Chu Hsu
Yu-Hsiang Su
Ling-Chien Hung
Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus
The Scientific World Journal
title Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus
title_full Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus
title_fullStr Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus
title_full_unstemmed Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus
title_short Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus
title_sort underestimated rate of status epilepticus according to the traditional definition of status epilepticus
url http://dx.doi.org/10.1155/2015/801834
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