Factors affecting seizure recurrence in the emergency department

Dolek U.C. Gokce M. Islam M.M. Ozdemir S. Aksel G. Algin A.
15 March 2024 Elsevier Ltd

Heliyon
2024 #10 Issue 5

Background: Information on Emergency Department (ED) follow-up of patients presenting with epileptic seizures is limited. Objectives: It was planned to investigate the factors affecting the recurrence of epileptic seizures in the follow-up of patients presenting to the ED with the complaint of epileptic seizures. Materials and methods: This prospective, observational, single-center study was carried out in an adult population presenting to the ED. The study included patients older than 18 years of age presenting to the ED with the complaint of epileptic seizures. Results: Of the 205 patients included in the study, 68 (33.2%) had seizure recurrence during the 6 h. In the univariable analysis, advanced age, prolonged post-ictal duration, increased seizure duration, generalized tonic clonic seizure, alcohol consumption within past 24 h, hypertension, coronary artery disease, Alzheimers disease, prior ischemic cerebrovascular disease, low Glascow Coma Scale (GCS), high glucose, high C-Reactive Protein, high phosphorus, low potassium, high blood urea nitrogen, high lactate, increased anion gap, high osmolarity were statistically significant in predicting recurrent seizure recurrence within 6 h. According to the logistic regression, postictal duration, GCS score, and age were independent predictors in our model. The cut-off value of postictal duration in predicting seizure recurrence at the highest sensitivity (66.2%) and specificity (89.8%) was 22.5 min. Conclusion: A prolonged postictal state, low GCS score, advanced age may be an indication of seizure recurrence. Therefore, patients with a long postictal duration, low GCS score, advanced age should be followed up more carefully in terms of recurrent seizures in the ED.

Epilepsy cluster , Immediate seizure , Recurrent epilepsy , Recurrent seizure

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Khoja Akhmet Yassawi International Kazakh-Turkish University, Medical School, Emergency Department, Turkistan, Kazakhstan
Emergency Medicine Department, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
Khoja Akhmet Yassawi International Kazakh-Turkish University, Medical School, Department of Neurology, Turkistan, Kazakhstan

Khoja Akhmet Yassawi International Kazakh-Turkish University
Emergency Medicine Department
Khoja Akhmet Yassawi International Kazakh-Turkish University

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