Moon JM, et al. – Researchers aimed to examine the predictive factors for progression from seizure–related endosulfan poisoning to status epilepticus (SE) and refractory SE (RSE), they also investigate delayed neurologic sequelae in seizure–related endosulfan poisoning. Compared to other drug–induced seizures, seizure–related endosulfan poisoning had higher progression rates to SE and RSE and higher fatality rates. However, delayed neurologic sequelae after discharge were not shown. Physicians had to aggressively treat patients who experienced a seizure after endosulfan poisoning and who presented with decreased Glasgow coma scale (GCS) score 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. For controlling seizures, lorazepam had to be considered a first–line anti–epileptic drug in patients with endosulfan poisoning.

Methods

• The researchers performed this retrospective, observational case series consisted of 73 patients who developed at least one seizure after endosulfan ingestion.

Results

• 78.1% and 54.4% were the progression rates from seizure-related endosulfan poisoning to SE and from SE-related endosulfan poisoning to RSE, respectively.
• 19.2% and 41.9% were the SE and RSE fatality rates, respectively.
• In this study, no patients reported the development of delayed neurological sequelae at least 6 months after discharge.
• The researchers identified Glasgow coma scale (GCS) score 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 correlated with preventing progression from SE-related endosulfan poisoning to RSE.