Severe seizures are on the rise, particularly among minorities

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By Denise Mann

Health Day Reporter

MONDAY, December 5, 2022 (HealthDay News) — More Americans are suffering from prolonged, life-threatening seizures known as status epilepticus, and blacks are nearly twice as likely to experience these seizures as whites.

These are the key findings of new research looking at hospitalizations for status epilepticus from 2010 to 2019 in the United States.Status epilepticus is a seizure that lasts longer than 5 minutes. Some people may experience convulsions in this condition, while others may appear confused or as if they are daydreaming. Status epilepticus is an emergency and requires hospital treatment.

The study wasn’t supposed to say why these severe seizures are increasing, but the researchers have their theories. “It may be related to multiple causes, including changing definitions of status epilepticus over time,” said study author Dr. Gabriela Tantillo. (Previously, only seizures lasting more than 20 minutes were considered status epilepticus.)

Also, there is “a greater recognition of seizures, including non-convulsive seizures, by the medical community and the general public,” said Tantillo, an assistant professor of neurology at Baylor College of Medicine in Houston.

For the study, researchers screened nearly 490,000 hospital admissions for status epilepticus. These rates increased significantly over the study period, particularly among minorities.

In addition, minorities with status epilepticus are more likely to need advanced treatments, including a ventilator or feeding tube.

“I was surprised to see that disparities in the incidence of status epilepticus among minorities unfortunately persist and even widened from 2010 to 2019, despite greater awareness of status epilepticus and seizures and changes in insurance with increasing coverage over time of the time,” said Tantillo.

According to the study, older adults with status epilepticus were up to six times more likely to die and required ventilator or feeding tubes during a hospital stay than younger people with these seizures.

The researchers also found that electroencephalogram (EEG) monitors, which record electrical activity in the brain, became more widely available for people with higher incomes or for those being treated in city teaching hospitals.

There are things that will help make care more equitable for people with status epilepticus, Tantillo said. “We need to understand the underlying causes of status epilepticus as they are differentiated by socio-demographic factors, which requires more research and investment from government, community groups and philanthropy,” she noted.

Status epilepticus can be the result of uncontrolled epilepsy, a brain hemorrhage, a brain tumor, or a serious underlying condition like meningitis, she explained.

“In potentially preventable cases of status epilepticus, such as in people with epilepsy, improving health literacy and reducing the stigma associated with seizures in the community would help more patients get the treatment they need,” Tantillo said.

Minorities in the studies were less likely to die from status epilepticus. This may be because people with status epilepticus do better than their peers who have other causes of the condition, such as low levels of antiepileptic medication, because of low levels of antiepileptic drugs. B. a cerebral hemorrhage or lack of oxygen in the brain.

Expanding access to outpatient care can also help fill some of these gaps, Tantillo said.

In addition, work on diversifying the medical workforce in neurology could also improve trust and communication between patients and physicians, and reduce implicit bias and health inequalities over time, Tantillo suggested.

“The results are terrible, but not surprising,” said Dr. Daniel Lowenstein. He is Professor and Vice Chair of Neurology at the University of California, San Francisco. “The overall picture is that it again highlights disparities that exist within the healthcare system based on race and socioeconomic class.”

Such differences can be seen in the diagnosis and treatment of many diseases and conditions, he noted.

Treatment for status epilepticus involves intervening as early as possible with a benzodiazepine and/or other antiseizure drugs, said Lowenstein, who was not involved in the new study. How well someone is doing depends on the underlying cause, as some causes are more treatable than others.

The findings were presented Friday at the American Epilepsy Society’s annual meeting in Nashville. Results presented at medical congresses should be considered preliminary until published in a peer-reviewed journal.

More information

The Epilepsy Foundation has more on status epilepticus.

SOURCES: Gabriela Tantillo, MD, MPH, Assistant Professor, Neurology, Baylor College of Medicine, Houston; Daniel Lowenstein, MD, Robert B. and Ellinor Aird Professor and Vice Chair, Neurology, University of California, San Francisco; Presentation, American Epilepsy Society, Annual Meeting, December 2-6, 2022

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Severe seizures are on the rise, particularly among minorities
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