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Risk factors of status epilepticus in children
Serap KarasalIhoGlu1, Naci Oner, CoSkun CeLtik
1Departments of Pediatrics and Neurology, University of Trakya, Faculty of Medicine, Edirne, Turkey.
Insights
Identifying risk factors for status epilepticus (SE) in children is crucial. Polypharmacy, medication discontinuation, neuromotor retardation, and abnormal EEGs independently predict higher SE risk.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Risk Factor Analysis
Background:
- Status epilepticus (SE) is a critical neurological emergency with significant morbidity and mortality.
- Limited research exists on the specific risk factors contributing to SE in pediatric populations.
Purpose of the Study:
- To identify and assess the independent risk factors associated with the occurrence of status epilepticus (SE) in children.
Main Methods:
- A retrospective case-control study was conducted, comparing 83 pediatric patients diagnosed with SE to 166 controls with non-SE seizures.
- Medical records were reviewed for potential risk factors including birth history, seizure types, medication adherence, neurological status, and diagnostic imaging/EEG findings.
Main Results:
- Univariate analysis revealed associations between SE and birth asphyxia, neonatal seizures, antiepileptic drug (AED) discontinuation, epilepsy history, seizure evolution, neurological abnormalities, and polypharmacy.
- Multiple logistic regression identified polypharmacy (OR 5.17), AED discontinuation (OR 4.04), neuromotor retardation (OR 4.03), and generalized EEG abnormalities (OR 2.48) as significant independent predictors of SE risk in children.
Conclusions:
- Polypharmacy, discontinuation of antiepileptic medication, neuromotor retardation, and generalized background abnormalities on electroencephalogram (EEG) are key indicators of elevated status epilepticus risk in pediatric patients.
Background:
Although there is abundant literature about the morbidity and mortality rates of status epilepticus (SE), little is known about the risk factors of this medical emergency. The aim of the present study is to assess the risk factors of SE in children.
Methods:
The authors reviewed the medical records of 83 patients admitted to the Pediatric Neurology Unit of Trakya University Hospital, Edirne, Turkey from January 1994 to December 2001 with the diagnosis of SE. Eighty-three patients were compared with 166 controls who were admitted to the same unit due to non-status epilepticus (non-SE) seizure.
Results:
The univariate analysis demonstrated that SE episodes were significantly associated with a history of birth asphyxia, neonatal seizure, discontinuation of antiepileptic medication, epilepsy, partial seizure evolving to secondary generalized seizures, myoclonic seizure, generalized abnormalities in the neurological examination, neuromotor retardation, generalized background abnormalities on electroencephalogram (EEG), generalized abnormalities on neuroimaging and polypharmacy than non-SE episodes. Logistic regression was used to test the independence of these parameters as predictors of SE risk. Four parameters emerged as significant independent predictors of SE in children in multiple logistic regression: polypharmacy (Odds ratio (OR) 5.17, P = 0.0004), discontinuation of antiepileptic medication (OR 4.04, P = 0.0095), neuromotor retardation (OR 4.03, P = 0.0016) and generalized background abnormalities on EEG (OR 2.48, P = 0.0419).
Conclusion:
Polypharmacy, discontinuation of antiepileptic medication, neuromotor retardation and generalized background abnormalities on EEG are indicators in children of a higher risk of SE.