TITLE:
Management of 468 Status Epilepticus Cases in the Intensive Care Unit of the University Teaching Hospital of Yaoundé
AUTHORS:
Ernest Dallé, Frederic Melaman Sego
KEYWORDS:
Status Epilepticus, Therapeutic Approach, UTH, ICU
JOURNAL NAME:
World Journal of Neuroscience,
Vol.16 No.4,
November
10,
2026
ABSTRACT: Purpose: Status epilepticus (SE) constitutes a therapeutic emergency for medical practitioners working in the Intensive Care Unit (ICU). Here, we highlight and propose a contextualized medical approach for the efficient management of SE in a 1st-class clinical setting, mostly attended by a low-income population. Methods: A total of 468 cases of patients presenting with seizures were received at the ICU of the University Teaching Hospital (UTH) of Yaoundé. From: 1) the recognition of the diagnosis, 2) the search for the etiology, 3) the cessation of convulsions, 4) the administration of appropriate treatment medication that stops the seizures before referring to the specialist, we accumulated critical information to understand and tailor our therapeutic approaches for SE. Results: A total of 319 (68.16%) of patients with seizures were associated with loss of consciousness, tonic and/or clonic movements of the extremities, signs of tongue biting, and incontinence. Only 83 (26.0%) patients with SE failed to respond to first- and second-line anticonvulsant treatment administered. The mortality rate for SE varied from 5% (16/319) in simple cases to over 30.2% (45/149) in severe or super-refractory cases. We have identified direct factors associated with the severity of SE and indirect factors to be considered when choosing a specific treatment. Diazepam, Lorazepam, or Midazolam were the best options to stop the seizures, while Levetiracetam, Depakine, Phenobarbital, or Tegretol were recommended for maintenance. Conclusion: For successful management of SE, the choice of one or two first-line medications to stop the seizure before it becomes refractory is critical.