The burden of seizure emergencies in spain: a systematic literature review.

INTRODUCTION

Seizure emergencies pose significant clinical and healthcare challenges in Spain, impacting morbidity, mortality, and resource utilization. Comprehensive data on epidemiology, clinical outcomes, and economic impact remain limited.

METHODS

A systematic review was conducted following the Centre for Reviews and Dissemination (CRD), Cochrane, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Embase, PubMed, and CINAHL were searched (January 2010-April 2025) for observational studies on epileptic seizure emergencies in Spain. Study selection, data extraction, and risk of bias assessment (ROBINS-I) were performed independently by two reviewers. Given reporting heterogeneity, a descriptive narrative synthesis was undertaken.

RESULTS

Forty-seven observational studies identified 16 population groups. The analysis focuses on two groups with the most comprehensive data: status epilepticus (SE), epileptic seizures at the emergency department; and in pediatric populations. SE patients experienced extended seizure duration (8-51 h), in-hospital mortality averaging 24.3%, intensive care unit (ICU) admissions between 17% and 48%, and hospital stays up to 24 days, indicating substantial resource utilization. Patients with epileptic seizures at the emergency department exhibited hospitalization rates between 6-32% and medical complications between 19.4% and 52.1%. Pre-hospital benzodiazepines use was between 11 and 38%. Pediatric likely underrepresented populations had lower mortality but frequent emergency visits. No studies assessed quality of life or indirect costs; one reported direct cost in SE.

CONCLUSION

Reporting of seizure emergencies in Spain is heterogeneous and biased toward severe cases, likely overestimating per-patient burden while underestimating population impact. Broader data capture and improved early management could inform planning and reduce overall burden.