Seizures that occur in patients admitted to the hospital for nonseizure reasons are likely to recur during the hospital stay, usually carry a high risk of mortality and morbidity, and often are not treated optimally, researchers reported in the online January 14 JAMA Neurology.
In a retrospective study of 218 patients who had seizures when they were inpatients at medical, surgical, or emergency departments at two New York hospitals, the overall rate of death or discharge to hospice care was 14%, said Madeline C. Fields, MD, of the Department of Neurology at Mount Sinai School of Medicine, New York City, and colleagues.
A Need for Management Guidelines
The investigators sought to describe the epidemiology of hospital-onset seizures, because until now, no studies in the United States had done so. No management guidelines are available for clinicians, and even the usefulness of antiepileptic drugs (AEDs) is uncertain. “This is surprising considering that hospital-onset seizures are dramatic events that often lead to increased intensity of medical care, consultations, and prolonged hospital stays,” the authors noted.