Neurology ·
Late EEG Risk and MRI Diffusion Abnormalities Linked to Deficits After Status Epilepticus
A two-center observational study of 221 patients with confirmed status epilepticus found that restricted diffusion on MRI and high-risk findings on late EEG were associated with neurological deficits at discharge. Associations were strongest in the subgroup with remote symptomatic status epilepticus or preexisting chronic focal epilepsy; the findings do not establish causation.
- Late EEG risk findings were linked to discharge deficits.
- Restricted diffusion was independently associated with both outcomes.
- Seizure duration was not independently associated after adjustment.
This two-center observational study included consecutive patients with status epilepticus (SE) from 2017 to 2025. Of 440 patients with suspected SE, 297 had confirmed SE; 221 with an identified seizure focus formed the overall cohort, including 127 with remote symptomatic SE or preexisting chronic focal epilepsy. Researchers assessed seizure duration of at least 30 minutes, a 2HELPS2B score of 2 or higher on EEG performed the following day or later, and SE-related restricted diffusion on MRI. Outcomes were neurological worsening and SE-attributable focal deficits at discharge.
In the overall cohort, 96 patients (43.4%) had neurological worsening and 68 (30.8%) had focal deficits. High-risk findings on late EEG were associated with both outcomes in the overall and remote-or-chronic cohorts; high-risk findings on early EEG were not. In adjusted analyses, restricted diffusion was independently associated with both outcomes. In the remote-or-chronic cohort, its association with focal deficits was strongest (adjusted OR 28.59, 95% CI 7.23–154.99). Late EEG risk findings were also associated with focal deficits in that subgroup (adjusted OR 4.26, 95% CI 1.35–14.24), while seizure duration was not independently associated with either outcome. The observational results support these markers as potential complements to seizure duration when estimating seizure burden and brain injury, but do not establish causation or show that using the markers improves outcomes.
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Epilepsia: Late electroencephalographic seizure‐risk findings and restricted diffusion on magnetic resonance imaging as seizure‐burden markers associated with neurological deficits after status epilepticus in a remote or chronic cohort ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.