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Seizure. 2017 Oct;51:43-49. doi: 10.1016/j.seizure.2017.07.009. Epub 2017 Jul 29.

In-hospital outcomes and delayed neurologic sequelae of seizure-related endosulfan poisoning.

Author information

1
Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea.
2
Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, South Korea. Electronic address: emdrmjm@gmail.com.

Abstract

PURPOSE:

This study investigated the predictive factors for progression from seizure-related endosulfan poisoning to status epilepticus (SE) and refractory SE (RSE). This study also investigated delayed neurologic sequelae in seizure-related endosulfan poisoning.

METHODS:

This retrospective, observational case series consisted of 73 patients who developed at least one seizure after endosulfan ingestion.

RESULTS:

The progression rates from seizure-related endosulfan poisoning to SE and from SE-related endosulfan poisoning to RSE were 78.1% and 54.4%, respectively. The SE and RSE fatality rates were 19.2% and 41.9%, respectively. No patients reported the development of delayed neurological sequelae at least six months after discharge. Glasgow coma scale (GCS) score were identified as an independent factor for progression from seizure-related endosulfan poisoning to SE and from SE-related endosulfan poisoning to RSE. Lorazepam administration was independently associated with preventing progression from SE-related endosulfan poisoning to RSE.

CONCLUSION:

Seizure-related endosulfan poisoning had higher progression rates to SE and RSE and higher fatality rates than other drug-induced seizures. However, delayed neurologic sequelae after discharge were not demonstrated. Due to the high progression rates from seizure-related endosulfan poisoning to SE and RSE and the absence of an established treatment for SE-related endosulfan poisoning, physicians should aggressively treat patients who experience a seizure after endosulfan poisoning and who present with decreased GCS score. Lorazepam should be considered a first-line anti-epileptic drug for controlling seizures in patients with endosulfan poisoning.

KEYWORDS:

Endosulfan; Outcome; Seizures; Status epilepticus

PMID:
28787683
DOI:
10.1016/j.seizure.2017.07.009
[Indexed for MEDLINE]
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