Alcohol abuse has a potential association with unfavourable clinical course and brain atrophy in patients with status epilepticus. Issue 4 (April 2022) - Kurokawa, M.
Abstract : AIM: To evaluate chronological changes on serial magnetic resonance imaging (MRI) examinations and clinical prognosis in patients with status epilepticus (SE), as well as the effect of alcohol abuse and heavy alcohol use on clinicoradiological findings. MATERIALS AND METHODS: This retrospective, single-centre study was approved by the institutional review board. Among 345 patients with seizures between January 2010 and October 2021, 27 patients with SE who had undergone both initial MRI (within a week after onset) and follow-up MRI (within 1 month after the initial MRI) were included. Five and three patients with concurrent or previous alcohol abuse and heavy alcohol-use history were included, respectively, and they were classified into the AL (Alcohol use) group. The remaining 19 patients were classified into the non-AL group. Two neuroradiologists independently evaluated both initial and follow-up MRI examinations of each patient; MRI findings were compared between the AL and non-AL groups using Fisher's exact test. In 15 patients, including four patients from the AL group, clinical information 6 months after the onset of SE was available; this information was compared between the two groups. RESULTS: Brain atrophy (5/8 versus 2/19, p= 0.011; odds ratio, 12.29 [95% confidence interval, 1.32–189.2]) and unfavourable clinical course with uncontrollable seizures (3/4 versus 1/11, p= 0.033; odds ratio, 30[1.43–638.19]) were significantly more frequent in the AL group than in the non-AL group. CONCLUSION: Among patients with SE, alcohol abuse and heavy alcohol-use history were associated with unfavourable seizure control and brain atrophy. Highlights: T2WI/FLAIR hyperintensity and hyperperfusion on ASL and MRA are frequent in SE. Brain atrophy on follow-up MRI was significantly more common in the AL group. Uncontrollable seizures remained significantly more frequent in the AL group.