Dittrich, Tolga D. and Baumann, Sira M. and Semmlack, Saskia and De Marchis, Gian Marco and Hunziker, Sabina and Rüegg, Stephan and Marsch, Stephan and Tschudin-Sutter, Sarah and Sutter, Raoul. (2021) Diagnostic yield of cerebrospinal fluid analysis in status epilepticus: an 8-year cohort study. Journal of Neurology, 268 (9). pp. 3325-3336.
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Official URL: https://edoc.unibas.ch/82298/
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Abstract
We investigate the frequency and diagnostic yield of cerebrospinal fluid (CSF) analysis in adult patients with status epilepticus (SE) and its impact on the outcome.; From 2011 to 2018, adult patients treated at the University Hospital Basel were included. Primary outcomes were defined as the frequency of lumbar puncture and results from chemical, cellular, and microbiologic CSF analyses. Secondary outcomes were differences between patients receiving and not receiving lumbar puncture in the context of SE.; In 18% of 408 patients, a lumbar puncture was performed. Of those, infectious pathogens were identified in 21% with 15% detected ± 24 h around SE diagnosis. 74% of CSF analyses revealed abnormal chemical or cellular components without infectious pathogens. Screening for autoimmune diseases was only performed in 22%. In 8%, no or late (i.e., > 24 after SE diagnosis) lumbar puncture was performed despite persistent unknown SE etiology in all, transformation into refractory SE in 78%, and no recovery to premorbid neurologic function in 66%. Withholding lumbar puncture was associated with no return to premorbid neurologic function during hospital stay independent of potential confounders. Not receiving a lumbar puncture was associated with presumed known etiology and signs of systemic infectious complications.; Withholding lumbar puncture in SE patients is associated with increased odds for no return to premorbid neurologic function, and CSF analyses in SE detect infectious pathogens frequently. These results and pathologic chemical and cellular CSF findings in the absence of infections call for rigorous screening to confirm or exclude infectious or autoimmune encephalitis in this context which should not be withheld.
Faculties and Departments: | 03 Faculty of Medicine 03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) 03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) 03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch) 03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch) 03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Neurologie 03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Neurologie 03 Faculty of Medicine > Departement Klinische Forschung |
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UniBasel Contributors: | Sutter, Raoul Christian |
Item Type: | Article, refereed |
Article Subtype: | Research Article |
Publisher: | Springer Verlag |
ISSN: | 0340-5354 |
e-ISSN: | 1432-1459 |
Note: | Publication type according to Uni Basel Research Database: Journal article |
Identification Number: |
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Last Modified: | 31 Aug 2021 09:46 |
Deposited On: | 31 Aug 2021 09:46 |
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