[Status epilepticus as a cause of hospitalization]

Status epilepticus (SE) in children as the most severe, life-threatening condition requires rapid, correct, standard and efficient treatment. The results depend on the properly coordinated management at patient's home, emergency, intensive care units and pediatric neurology departments.

The aim of this research was to recognise type of diagnostic and therapeutic problems in children hospitalized with SE. Differences between two groups of children: I group with SE as the first manifestation of epilepsy and group II with epilepsy treated before occurrence of SE were studied as well.

In this retrospective study, 33 hospitalizations of 24 children (14 boys and 10 girls) aged 5 months to 15 years (mean 7 years) were analysed. Patients with SE hospitalized in the Intensive Care Unit and Emergency Department, Collegium Medicum Jagiellonian University in Cracow between 1.01.2002 and 31.12.2004 were included. The group I consisted of 13 children (54%) and the group II consisted of 11 children. In both groups the age and gender of patients, duration of hospitalisation, necessity of assisted ventilation and thiopental coma were analysed. Causes of epilepsy and SE were studied as well.

Duration of SE before hospitalization, similar in both groups ranged between 30 minutes and 2 hours, counting to its termination in the hospital. The cause of epilepsy was established in 15/24 children. Out of 33 SE, 10 were provoked by hyperthermia in children of both groups. The probable risk factor of SE was the association with mental retardation. The mean age of SE occurrence was in I group 4 years, while in the II group 10 years (with epilepsy duration since 1,5 year of age). The mean duration of hospitalisation was similar in both groups (21:22 days), however children of the I group were hospitalized in the Intensive Care Unit shorter, almost twice (2,5:4,5 days) as compared to the II group; intubation was necessary less often (3:6) and assisted ventilation shorter (1,5:3 days), respectively. None of the children died due to SE during 3 years.

The better outcome of intensive care in children of group I may be a result of later occurrence of epilepsy. In the management of SE in children of group II, especially with recurrent SE, the early employment of intensive care procedures should be considered. The effective management of SE in the emergency department may help to prevent of death caused by SE in children.