Analysis of 247 Children with Status Epilepticus: Clinical Features and Prognosis

Abstract

Background: Status epilepticus (SE) is one of the most common neurological emergencies in childhood. However, the clinical features and prognosis are poorly characterized in China. Objectives: To summarize the clinical features and outcomes among Chinese children. Methods: Children aged from 29 days to 18 years with SE were included in Children’s Hospital of Fudan University. The demography, etiology, seizure types, treatment and outcome were analysed. The statistics were conducted by SPSS19. Results: There were 247 SE patients (F:M=1.25:1). The mean age was 2.4 years. Most of them had acute symptomatic SE (53.06%) including viral encephalitis (48.46%). Most of them had convulsive status epilepticus (83.4%), others had non-convulsive status epilepticus (16.6%). Most of them had combination therapy (74.89%). Lengths of follow-up ranged from 1 month to 3 years after onset of SE. Most of cases were bad outcome (73.80%). Etiology and neurological image were significant risk predictors by multiple logistic regression analysis. Mortality rate was 16.95%. Recurrence rate was 20.76%. Most of cases died within 1 month after onset of SE (65.0%). Most of cases also recurred within 1 month (81.63%). Duration of SE and mechanical ventilation were related to death by multiple logistic regression analysis. The number of antiepileptic drugs (AED) and anaesthetic treatment were related to recurrence of SE by Cox survival analysis. Conclusion: The proportion of SE was highest in children younger less than 1 year. The most common etiology of SE in children was acute symptomatic, especially viral encephalitis. The clinical features between CSE and NCSE were different. Risk factors between recurrence and death were different. The death rate was higher in cases with duration of SE ≥ 3 hours and mechanical ventilation. Maintenance treatment ≥ 3 AEDs and anaesthetic treatment were related to higher recurrence rate. These results suggested we can improve the prognosis by terminating seizure in time