CLINICAL CHARACTERISTICS AND EVALUATION OF TREATMENT OUTCOMES FOR REFRACTORY STATUS EPILEPTICUS WITH INTRAVENOUS MIDAZOLAM AT CAN THO CENTRAL GENERAL HOSPITAL FROM 2023 TO 2025
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Abstract
Background: Status epilepticus is a critical neurological emergency, with refractory status epilepticus being particularly concerning due to its lack of response to first- and second-line treatment regimens. Several studies have demonstrated seizure control with intravenous midazolam in refractory status epilepticus; however, the seizure cessation rates remain inconsistent. Objectives: To describe the clinical characteristics of patients with refractory status epilepticus and to evaluate treatment outcomes of intravenous midazolam infusion at Can Tho Central General Hospital from 2023 to 2025. Materials and methods: A cross-sectional descriptive study was conducted on patients diagnosed with status epilepticus at Can Tho Central General Hospital. The criteria for evaluating treatment outcomes included: (1) seizure cessation (defined as no clinical seizures observed continuously for ≥ 24 hours after the last episode); (2) functional outcome at discharge according to the modified Rankin Scale (mRS) (0-2: favorable, 3-6: unfavorable); (3) mortality rate in the group without seizure cessation. Results: The most common type of refractory status epilepticus was bilateral tonic-clonic seizures, accounting for 77.8% of cases. The proportion of patients with refractory status epilepticus was 52.9%. The maximum intravenous midazolam infusion dose ranged from 0.05 to 0.5 mg/kg/h. Seizure cessation was achieved in 83.3% of cases. The mortality rate among patients who did not achieve seizure cessation was 66.7%, which was more than twice as high as the non-mortality rate (33.3%) in this group. Conclusions: The majority of refractory status epilepticus cases involved bilateral tonic-clonic seizures (77.8%). The proportion of patients with refractory status epilepticus was 52.9%. The maximum intravenous midazolam infusion dose was 0.05-0.5 mg/kg/h. The seizure cessation rate with intravenous midazolam infusion was 83.3%. The mortality rate among patients without seizure cessation was 66.7%.
Keywords
Refractory status epilepticus, Midazolam, the result of terminating, mortality rate
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