Convulsive Status EPILEPTICUS

Status epilepticus is a life-threatening neurological emergency characterized by prolonged seizures or multiple seizures occurring without the patient regaining consciousness between episodes. Convulsive status epilepticus is associated with high rates of morbidity and mortality if not promptly recognized and controlled. While prognostic factors have been studied in various populations, data regarding clinical predictors and hospital outcomes in Upper Egypt remain limited. The purpose of this prospective, hospital-based observational study is to identify the clinical predictors of short-term outcomes among adult patients presenting with convulsive status epilepticus admitted to Assiut University Hospitals. All eligible participants aged 18 years and older admitted with convulsive status epilepticus will receive standard-of-care medical management according to institutional clinical protocols. Researchers will systematically collect clinical data, including demographic factors, seizure semiology and duration, underlying etiologies, laboratory tests, neuroimaging findings, and electroencephalography (EEG) results. Participants will be followed throughout their hospital stay to assess functional outcome at discharge using the Modified Rankin Scale (mRS), in-hospital mortality, response to antiseizure treatment, development of refractory or super-refractory status epilepticus, requirement for intensive care unit (ICU) admission or mechanical ventilation, and length of hospital stay.

The goal of this pragmatic, decentralized, pre-consented, event-driven, randomized controlled trial is to investigate the efficacy of add-on ketamine to second-dose midazolam for prehospital treatment of epileptic children with convulsive status epilepticus.