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Epileptic seizures in the pediatric intensive care unit setting

Ignacio Valencia1, Germán Lozano, Sanjeev V Kothare

  • 1Section of Neurology, Department of Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA 19134, USA. ignacio.valencia@drexelmed.edu

Epileptic Disorders : International Epilepsy Journal with Videotape
|December 8, 2006
PubMed

Insights

Pediatric intensive care unit (PICU) seizures differ from adult patterns, with epilepsy and post-craniotomy conditions being common causes. Prompt diagnosis and treatment are crucial for better outcomes in pediatric seizure management.

Area of Science:

  • Pediatric Intensive Care
  • Neurology
  • Clinical Medicine

Background:

  • Seizures in the pediatric intensive care unit (PICU) are not well-characterized.
  • Adult ICU studies show seizure incidence from 0.8% to 3.3%, with vascular, metabolic, and drug withdrawal as common causes.

Purpose of the Study:

  • To investigate the clinical characteristics of seizures in children admitted to the PICU.
  • To understand the unique features of pediatric seizures in an intensive care setting.

Main Methods:

  • Retrospective review of 6,820 PICU admissions from 2002 to 2004.
  • Analysis of 32 pediatric patients (1 month to 19 years) who experienced seizures in the PICU.

Main Results:

  • Seizure incidence in the PICU was 0.5%.
  • Common etiologies included epilepsy (34%), post-craniotomy (23%), febrile seizures (14%), encephalitis (14%), and hydrocephalus (14%).
  • Generalized seizures occurred in 81%, and 34% experienced status epilepticus; 97% were treated with lorazepam or fosphenytoin.

Conclusions:

  • Pediatric PICU seizures exhibit distinct clinical characteristics compared to adults.
  • Identifying common PICU seizure etiologies aids prompt and effective treatment.
  • Neurological consultation and EEG are vital for diagnosing epileptic disorders in the PICU; antiepileptic drug prophylaxis may benefit post-craniotomy patients.
Abstract

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