Can We Predict the prognosis in patients with Acute Symptomatic Seizure? A Prognostic model: A Retrospective study from a developing nation (P2.272)

Objective: We aim to create a prognostic model for patients with Acute symptomatic seizure (AS). Background: There is a scarcity of data regarding the prognostic significance of patients with AS, especially from a developing nation Design/Methods: Between December 2014-August 2016, we retrospectively reviewed the clinical, laboratory, EEG and radiological data of patients with AS. Patients were classified to have good and poor outcome at discharge based upon modified rankin scale (poor outcome= mRS 4 and above, good outcome mRS 3 or less). Appropriate statistical tests were applied. Results: Out of 192 patients, 131 (68.2%) were males. One hundred and thirty-nine (72.4%) patients had good outcome and 53 (27.6%) patients had poor outcome. The etiology of AS was vascular (infarct-68, cortical venous sinus thrombosis- 20, parenchymal bleed-10, posterior reversible leukoencephalopathy-7, subarchnoid hemorrhage-5, arterio-venous malformation-4, dural arterio-venous fistula-2), infection (41), metabolic (17), traumatic brain injury (5), autoimmune encephalitis (4), alcohol related (3). One hundred and fourty-two patients presented with generalized seizures. Complex partial seizures and simple partial seizures were seen in 36 and 14 patients respectively. EEG data was available for 119 patients. Fifty-five patients (46%) had mild diffuse slowing of background activity (BGA) in theta range, 27 (23%) patients had moderate slowing of BGA and 4 (3%) patients had severe bihemispheric dysfunction. Epileptiform abnormalities were seen in 34 (29%) patients. Factors predicting poor outcome were old age (p=0.01), glassgow coma scale (GCS) at entry (p=0.001), vascular etiology (p=0.003) and severe electrophysiological dysfunction in EEG (p=0.009). Conclusions: The most common etiology of AS was vascular due to ischemic stroke and cortical venous sinus thrombosis. Old age, poor GCS at entry, vascular etiology and severe electrophysiological dysfunction in EEG predicted poor outcome in patients with AS at discharge. Disclosure: Dr. Dash has nothing to disclose. Dr. parajapati has nothing to disclose. Dr. Patanvadiya has nothing to disclose.