Abstract
Objectives: To review the clinical character, the management and outcome of status epilepticus in children. Methodology: We conducted a retrospective review of 54 cases treated between 1996 and 1997 at the Royal Alexandra Hospital for Children, Sydney, Australia. Among the variables collected for analysis in this study were age, sex, etiology of status epilepticus, median length of Paediatric Intensive Care Unit (PICU) stay and days of mechanical ventilation, and mortality of status epilepticus. Results: Of the patients with status epilepticus, 61% were male and 39% female, with an age range of 3 months to 15 years (mean 5.3 years). The etiology of status epilepticus is largely age related, with acute causes common in 1 - 3 year and 4 - 7 year ages, 44 cases (81.5%). The etiology of status epilepticus included febrile (35.18%), acute symptomatic (27.58%) and idiopathic (16.6%), total was 44 cases (81.4%). Median length of PICU stay and days of mechanical ventilation were 3.02 ± 1.6 days and 1.24 ± 0.5 days respectively. Mortality was 5.3%. Most patients were treated with diazepam and phenytoin. The total number of the patients with a favorable outcome was 41 (75.89%). Conclusions: One of the most common neurologic emergencies in children of status epilepticus remains a major problem in morbidity and mortality. There are multiple causes of status epilepticus that include the categories of idiopathic, febrile, acute symptomatic and remote symptomatic. Intravenously administered phenytoin and diazepam remains the first-line therapy for status epilepticus. Most of the patients will respond to this treatment. The etiology of status epilepticus included febrile (35.18%), acute symptomatic (27.58%), idiopathic (16.6%) and total was 44 (81.4%).
Highlights
Status epilepticus (SE) is one of the most common emergencies in paediatric neurology and is associated with a high mortality and morbidity, with an incidence of 20 per 100,000 children per year [1] [2]
Among the variables collected for analysis in this study were age, sex, etiology of status epilepticus, median length of Paediatric Intensive Care Unit (PICU) stay and days of mechanical ventilation, and mortality of status epilepticus
Our data showed that for the etiology of SE, half were idiopathic and febrile, 9 (16.6%) and 19 (35.18%) respectively, infection is one of the major causes with a total of 9 (16.66%) cases
Summary
Status epilepticus (SE) is one of the most common emergencies in paediatric neurology and is associated with a high mortality and morbidity, with an incidence of 20 per 100,000 children per year [1] [2] It is more frequent in children than in adults and occurs in a variety of settings, especially in children with infections, and patients with previously established epilepsy, cerebral malformations, hypoxia, hypoglycaemia and head trauma. This paper presents the etiological, clinical characteristics, effect of treatment and prognosis in a large group of children with status epilepticus, with special attention been paid to their intensive care course and the presence of anticonvulsant drug toxicity
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