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Infantile status epilepticus in Tunisia. Clinical, etiological and prognostic aspects
1Service de Pédiatrie, Hôpital Farhat Hached, Sousse, Tunisia. bmlaiki@excite.fr
Insights
Infantile status epilepticus in Tunisia, a significant public health issue, frequently stemmed from fever and acute symptomatic causes. This condition led to considerable mortality and long-term neurological problems, particularly in infants under one year old.
Area of Science:
- Pediatric Neurology
- Epileptology
- Public Health
Background:
- Status epilepticus in infants presents a significant global health challenge.
- Understanding the specific etiologies and outcomes in diverse populations is crucial for effective management.
- Previous research highlights the need for data from various geographic regions to inform public health strategies.
Purpose of the Study:
- To investigate the causes, clinical characteristics, and outcomes of infantile status epilepticus in Tunisia.
- To identify risk factors associated with mortality and neurological sequelae in this population.
- To provide data that can inform improved management and public health interventions.
Main Methods:
- Retrospective study design.
- Inclusion of 139 infants treated for status epilepticus between 1990 and 1997 at two Tunisian university hospitals.
- Data collection on seizure characteristics, etiology, treatment, mortality, and neurological sequelae during a mean follow-up of 3.5 years.
Main Results:
- The most common causes were febrile (57 cases) and acute symptomatic (56 cases).
- Generalized seizures were predominant (74%), with a duration of 30 minutes to 1 hour in 70% of cases.
- Overall mortality was 15.8%, and neurological sequelae were observed in 36% of cases, with higher incidence in infants under one year and those with acute symptomatic causes.
Conclusions:
- Fever and acute symptomatic causes are the leading triggers for infantile status epilepticus in Tunisia.
- Infantile status epilepticus poses a substantial public health burden due to significant mortality and morbidity.
- Timely access to appropriate medical care is essential to improve outcomes and reduce the impact of this condition.
Abstract:
This retrospective study includes 139 infants (74 girls and 65 boys) treated for status epilepticus at two University hospitals in Tunisia between 1990 and 1997. Their mean age was 11 months. The majority of seizures were generalized (74%) and lasted between 30 minutes and 1 hour (70%). The cause of status epilepticus was classified as acute symptomatic in 56, febrile in 57, remote symptomatic in nine, progressive neurologic in 10 and idiopathic in seven. Overall mortality was 15.8% and neurological sequelae were identified in 36% of the cases during the mean follow-up time of 3.5 years. The incidence of significant sequelae was a function of aetiology (especially acute symptomatic causes) and age (under 1 year of age). We conclude that the most frequent causes of infantile status epilepticus in Tunisia were fever and acute symptomatic causes. Status epilepticus among infants is an important public health problem, with significant associated mortality and morbidity. Management of status epilepticus can be improved by more rapid access to appropriate medical care.