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Status epilepticus in children: a five-year experience at Aga Khan University Hospital
S H Ibrahim1, M A Yezdan, S Q Nizami
1Department of Pediatrics, Aga Khan University, Karachi.
Insights
Status epilepticus, a serious neurological condition, has a high mortality rate in Pakistan. This study found no identifiable risk factors for this high mortality, despite known associations.
Area of Science:
- Neurology
- Pediatrics
- Critical Care Medicine
Background:
- Status epilepticus is an underdiagnosed neurological emergency in Pakistan.
- It is a potentially reversible condition with high mortality if not managed promptly.
Purpose of the Study:
- To determine the clinical profile of status epilepticus in Pakistani patients.
- To investigate the relationship between mortality and known risk factors for status epilepticus.
Main Methods:
- Retrospective study analyzing medical records of patients diagnosed with status epilepticus (ICD codes 345.30, 345.31) from 1998-2002.
- Data analysis using SPSS, chi-square, and Fischer exact tests.
Main Results:
- Twenty-four patients were included; 66.7% were male, with a mean age of 58 months.
- Mortality rate was 25%. Potential risk factors like age, MRI findings, and seizure duration were assessed.
- No significant relationship was found between mortality and identified risk factors.
Conclusions:
- Status epilepticus presents a significant mortality risk in the studied Pakistani population.
- Further research is needed to identify specific risk factors contributing to high mortality in this region.
Objective:
Status epilepticus is an under diagnosed entity in Pakistan. It is a potentially reversible condition but has a high mortality, if it is not recognized and managed on time. The purpose of this study was to determine the clinical profile and the relationship of mortality of status epilepticus with its known risk factors.
Methods:
This was a retrospective study. Medical records of all the patients admitted in the last five years (1998-2002) with a diagnosis of status epilepticus (ICDcode 345.30, 345.31) were reviewed. Data was recorded on a Performa and analyzed by using the statistical programme SPSS, chi square and Fischer exact test.
Results:
The total number of patients were twenty-four. Sixteen patients were males (66.7%). Mean age was fifty-eight months and mean duration of hospital stay 5.5 days (range 2 to 22days). Eight patients were diagnosed to have epilepsy. Four (16.7%) had a previous history of status epilepticus. Three patients presented with status epilepticus for the first time without any previous history of seizures. Ten patients required midazolam infusion (41.7%) and out of these 3 (12.5%) were also given thiopentone infusion to control the seizures. Nine patients were shifted to the ICU for ventilation and control of seizures. Mortality in our study was 25%. Risk factors for mortality included age less than or equal to one year, abnormal MRI, type of the status epilepticus and the total duration of status epilepticus. No significant relationship was found with any of the known risk factors
Conclusion:
Status epilepticus is a neurological emergency. A very high mortality was seen in our study. No risk factors were identified for this high mortality.
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