Status epilepticus in a population-based cohort with childhood-onset epilepsy in Finland

Little is known about the time course over which status epilepticus occurs in childhood-onset epilepsy and its impact on long-term prognosis. A population-based cohort of 150 children younger than age 16 years with new onset epilepsy between 1961 and 1964 residing in the catchment area of Turku University Hospital was observed prospectively until 1997. The occurrence of status epilepticus and recurrent status epilepticus, risk factors for status epilepticus, and the impact of status epilepticus on prognosis were examined. Of the 150 cases, 41 patients (27%) experienced an episode of status epilepticus of whom 22 patients (56%) had two or more episodes. The risk of status epilepticus was highest at the onset of the disorder with 30 (73%) cases occurring before (n = 12) or at (n = 18) onset and 37 (90%) cases within 2 years of onset. On multivariable analysis, risk factors for status epilepticus included remote symptomatic cause, age of onset 6 years or younger, and partial seizures. Specific epilepsy syndromes also were associated with a differential risk of status epilepticus. The occurrence of status epilepticus did not alter the mortality rates and had only a modest impact on the probability of attaining remission. In subjects with no other neurological handicap, social and educational outcomes were similar in those with status epilepticus and those with no history of status epilepticus. We conclude that status epilepticus is a common occurrence in childhood-onset epilepsy. When it does occur, it occurs early in the course of the disorder. The occurrence of status epilepticus does not appear to have significant adverse impact on long-term prognosis of childhood-onset epilepsy.