Status epilepticus: occurred in 3% of patients with fits.

Clinical bottom line (level 4)

Around 3% of patients who fitted had status epilepticus.
Tumours and vascular problems were the commonest causes.

Oxbury and Whitty: Brain 1971; 94: 733-744

Expires September 2003

The study

Case series with ?objective ?blinded outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: university hospital, UK 1947-67

86 patients (aged ?, ?% male) status epilepticus (defined as convulsions lasting > 1 hour, or 2 major fits without recovery of consciousness in between)

Excluded if

<11 years old

84% followed for uncertain
Outcomes studied:

tumour

vascular

infection

post-traumatic

congenital

frontal lobe damage from surgery

metabolic

The evidence

outcome	time to outcome	number of patients/total number	% (95% CI)
tumour	uncertain	19/86	22% (13% to 31%)
vascular	uncertain	13/86	15% (7.5% to 23%)
infection	uncertain	9/86	11% (4.0% to 17%)
post-traumatic	uncertain	4/86	4.7% (0.2% to 9.1%)
congenital	uncertain	4/86	4.7% (0.2% to 9.1%)
frontal lobe damage from surgery	uncertain	3/86	3.5% (0.0% to 7.4%)
metabolic	uncertain	2/86	2.3% (0.0% to 5.5%)

prevalence of status epilepticus in patients presenting with fits: 86/~2500: 3.4% (95% CI: 2.7% to 4.2%)
mortality: 43%

Comments

Little information about patients available; no information on how final diagnoses were made.
Study covered a long period of time with significant changes in management. Difficult to know how to apply these results to today's patients.

Citation

Oxbury JM, and Whitty CW: Causes and consequences of status epilepticus in adults: a study of 86 cases. Brain 1971; 94: 733-744

Contributor: Chris Ball and Clare Wotton, November 2000
Reviewer:

_{Clinical Question.}

_Patient	_{status epilepticus}
_{Intervention or Exposure}	_prevalence
_Outcome	_causes