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Published on: September 20, 2024
[Mortality in children with epilepsy. A clinical prospective study]
M Devilat Barros1, G Rivera Gómez, V Gómez Muñoz
1Hospital de Niños Luis Calvo Mackenna, Santiago de Chile, Chile.
Insights
Children with epilepsy face a significantly higher mortality risk, often linked to severe, resistant epilepsy and early disease onset. Comprehensive seizure control is crucial for improving outcomes in pediatric epilepsy.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Epidemiology
Background:
- Mortality rates in epilepsy patients exceed the general population.
- Data on mortality specifically in children with epilepsy is limited.
- Understanding risk factors and causes of death in pediatric epilepsy is essential for family support.
Purpose of the Study:
- To determine the mortality risk in children with epilepsy.
- To identify associated factors contributing to death in this population.
- To analyze causes of death and inform family support strategies.
Main Methods:
- A retrospective study of 16 children with epilepsy who died between 1996 and 2002.
- Data collected from medical records, a dedicated database, and parental interviews.
- Inclusion criteria followed a pre-established protocol for 15 of the deceased children.
Main Results:
- The standardized mortality ratio was 3.21 (95% CI: 1.48–4.95).
- Common factors included early onset, remote symptomatic epilepsy, and severe/catastrophic epilepsy.
- Infections and sudden unexpected death were the primary causes of mortality; polytherapy and multiple treatment schemes were frequent.
Conclusions:
- Pediatric epilepsy carries a high mortality risk, associated with severe, resistant, and catastrophic forms of the condition with early onset.
- Achieving complete seizure control should be the primary therapeutic objective.
- Family support during bereavement is an important consideration.
Introduction:
Mortality in patients with epilepsy is higher than the general population, but the data about children is not too extends. OBJECTIVES. To determine the risk of dying in epileptic children, the associated factors and the cause of death, as well as to target the support given to the family.
Patients And Methods:
From 1996 to 2002, sixteen children with epilepsy controlled in our centre died. Fifteen of them were included in our research according to a previous protocol. The data was token from our data bank, the clinical file and parents interview.
Results:
The standard mortality rate was 3.21 (95% CI: 1.48 4.95). The main group had an early onset on their illness. Thirteen children had remote symptomatic epilepsy. Eleven had resistant or catastrophic epilepsy. The EEG was specific for epilepsy in 11 cases. Nine children were receiving politherapy. Eight patients had received three or more therapeutic schemes. Eight had pre mortem therapeutic blood levels of antiepileptic drugs. Ten patients die because of infection and five because of a sudden unexpected death. In one of them the sudden unexpected death was definite and was given in a pregnant teenager with a juvenile myoclonic epilepsy. Other boy died soon after an earthquake. The assistance to the mourning elaboration was useful for the family.
Conclusions:
This children has a high risk of dying, it is associated to on early onset of severe, active, resistant and catastrophic epilepsy. The entire control of crisis should be the main target of treatment.
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