Epileptic Seizure States: Sociodemographic, Diagnostic, and Therapeutic Aspects—A Two-Center Study in Two University Hospitals in N’djamena

Introduction: Status epilepticus (SE) is a medical emergency defined by persistent or recurrent epileptic seizures. This bicentric study aims to describe the diagnostic characteristics of SE in Chad. Methodology: This was a prospective descriptive cross-sectional study conducted from January to December 2025 (12 months) at the National Reference University Hospital and La Renaissance University Hospital in N’Djamena, including all patients aged 15 years or older hospitalized for SE confirmed clinically or by electroencephalography. Data were collected from the neurology and intensive care units. Results: Among 1132 patients admitted for neurological hospitalization, 80 cases of SE were identified, representing 7.06%. The mean age was 45.7 ± 17.24 years. The male-to-female ratio was 2.47. At admission, 68.8% presented with convulsive seizures and 81.3% had generalized seizures. Generalized tonic-clonic status epilepticus represented 96.3% of cases. Altered consciousness (Glasgow score ≤ 8) was observed in 46.2%. Computed tomography, performed in 52.5% of patients, showed ischemic stroke (AVCI) in 21.4%. Electroencephalography, performed in 32.5% of cases, revealed abnormalities in 73.1%. The main etiologies were head trauma (27.5%) and cerebrovascular diseases (26.3%). Arterial hypertension (25%) and epilepsy (17.6%) were the predominant comorbidities encountered. Diazepam was used as first-line therapy in 73.7%. Second-line treatment was necessary in 95% of cases (phenobarbital 39.5% or phenobarbital-sodium valproate combination 26.3%). Conclusion: The frequency of SE was 7.06%, confirming its major clinical significance.