ABSTRACT 821

Abstract

Background and aims: Seizure is a common reason for hospital visits of children. However, little is known about the causes and management of acute seizures in children from the developing countries. Aims: The aims of this study was to identify the etiologies of seizure and appropriateness of initial treatment for acute seizures in children presenting at the Emergency Department of a tertiary hospital in Vietnam. Methods: This descriptive study was conducted at the Emergency Department of the National Hospital of Pediatrics, Hanoi, Vietnam during a period of January 2013 to June 2013. Demographic data, clinical manifestation, laboratory investigations, neuro-imaging results, the appropriateness of treatment, and outcome of seizure were collected from medical records. The study has had IRB’s approval from the hospital. Results: Of the 452 patients were admitted for seizures, 283 (62.6%) were males and 90.0% of these children were less than 5 years old. Generalized tonic-clonic seizures were the most common seizure type (84.7%) and majority (92.0%) of seizure episodes were less than 5 minutes. Febrile seizures (49.8%), epileptic disorders (30.8%), and central nervous system (CNS) infections (13.5%) were the most common etiologies. Abnormal brain images was noted in 31/152 patients (20.4%). Intravenous midazolam was the common medication for first-line treatment (88.2%), and 82.7% of seizure episodes were terminated after first-line treatment. A total of 31 patients developed recurrent seizures. Conclusions: Febrile convulsions, epileptic disorders, and CNS infections were common causes of seizures in children. Brain imaging should be considered for afebrile seizure episodes. Intravenous loading midazolam was effective first-line treatment for acute seizures.