Real-world Data on Adult Status Epilepticus from Latin America: Clinical Characteristics and Outcomes in a Mexican Tertiary Center

• This study represents the largest real-world cohort of adult status epilepticus (SE) in a Mexican center. • Acute symptomatic etiologies were the most common cause of SE. • Nonconvulsive SE was associated with poor functional outcomes. • Favorable outcomes were significantly associated with prior epilepsy. • Findings support risk stratification and tailored management in low-resource settings. Status epilepticus is a life-threatening emergency in neurology practice. Latin America faces a disproportionate epilepsy burden; little data is available on this population type. To describe the clinical characteristics, treatment approaches, and functional outcomes of adult patients with SE in a tertiary neurological center in Mexico City. We conducted a retrospective cohort study involving 103 adult patients diagnosed with SE from 2020 to 2024. Functional outcomes were measured using the modified Rankin Scale (mRS), with scores 0–2 classified as favorable. Severity was assessed with the STESS. Chi-square, Mann–Whitney U tests, and logistic regression were used to identify variables related to outcomes. The median patient age was 36 (IQR 18–79), with 50.5% of patients being female. Most had a prior diagnosis of epilepsy (80.6%). Convulsive SE (74.8%) and acute symptomatic etiologies (70.9%) were predominant. Infections were the leading cause among acute symptomatic cases (35%). Refractory SE occurred in 41.7% of cases, and 14.6% progressed to super-refractory SE. Favorable outcomes were significantly associated with prior epilepsy (p = 0.032), and SE subtype (p = 0.003). Multivariate analysis confirmed prior epilepsy as an independent predictor of good outcome (OR = 0.65, 95% CI 0.48–0.87; p = 0.004). This study offers the most extensive characterization of SE in a Mexican center. Infectious etiologies dominate the clinical landscape, with functional outcome linked to baseline epilepsy history and SE subtype