[Assessment of the prevalence rate of status epilepticus and its underlying factors among adults and children]

Status epilepticus is a medical emergency condition which has various causes among adults and children. Timely treatment and elimination of the underlying factors are important. Identification of its underlying factors in different societies can be helpful for diagnosis and treatment of this disorder. This study was conducted to investigate the underlying factors of status epilepticus and compare them between adults and children. This was a cross sectional study and included all adult patients with diagnosis of epilepsy who had been hospitalized in the internal medicine and neurology wards of Tohid Hospital and also all hospitalized children with epilepsy in the pediatric ward of Be'sat Hospital, in Sanandaj. According to the patients' records and documents the main cause of status epilepticus in every patient was extracted and recorded by a neurologist. Data were revised and chi-square and Fisher's test were used for data analysis and comparison of the qualitative variables between the two groups [adults and children]. This study included 504 patients. 212 patients [63.1%] in the children group and 87 patients [51.8%] in the adult group were male [p=0.01]. The prevalence rate of status epilepticus in the children and adults were 28.3% and 17.3% respectively. 29 children [26.3%] and 10 adults [34.5%] had previous history of epilepsy [p=0.39]. Moreover, 32 children [33.7%] and 4 adults [13.8%] had previous records of epilepsy within their family [p=0.04]. The most common causes of status epilepticus among adults were misuse or discontinuance of medications [34.5%], head trauma [20.7%], cerebrovascular problems [20.7%]. Among children febrile diseases [60%], misuse or discontinuance of antiepileptic medications [20%] and metabolic disorders [7.4%] were the most common causes of status epilepticus. It seems that epilepsy is not controlled properly in the patients and it is likely that patients do not use antiepileptic medications correctly. It is necessary to design plans to prevent head trauma. Also it seems the parents do not have enough knowledge of controlling fever in their children. Therefore, proper instructions should be given to the parents about the disease of their children.

[Brain death and unusual findings in brain CT scan: a case report]

Many finding in neuroimaging of brain death can mimic other disorders such as subarachnoid hemorrhage [SAH]. Here, we report a case of brain death with a CT scan mimicking SAH. Our patient was a 28 year old man who was transferred to Tohid Hospital because of decreased level of consciousness after drug overuse and also cardiopulmonary arrest. Brain CT scan at the stage of brain death showed increased density at the basal arteries of circle of Willis and deep venous structures which was suggestive of SAH and to lesser degree CVT. Lumbar puncture [L.P] revealed no RBC and WBC in CSF, and D-Dimer [a sensitive test for CVT] was less than 0.5mg/dl. Therefore the findings in the brain CT scan of our patient were associated with extensive thrombosis in the basal arteries and deep veins. Brain CT scan of a brain dead patient can mimic subarachnoid hemorrhage and cerebral vein thrombosis. Therefore history, clinical findings and paraclinical measures such as CT scan and LP can be useful for proper diagnosis