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Analysis of status epilepticus related presumed encephalitis in children

Jainn-Jim Lin1, Kuang-Lin Lin, Huei-Shyong Wang

  • 1Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #5 Fu-Shin Street, Kwei-Shan, Taoyuan 333, Taiwan.

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|June 23, 2007
PubMed

Insights

Status epilepticus (SE) related presumed encephalitis in children leads to high mortality and morbidity. Refractory status epilepticus (RSE) and multifocal or generalized EEG abnormalities significantly worsen outcomes.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Epileptology

Background:

  • Encephalitis is an acute brain infection presenting with fever, headache, and altered consciousness.
  • Seizures, including status epilepticus (SE), can be a prominent feature of childhood encephalitis.
  • Refractory status epilepticus (RSE) represents a severe form of SE with poor prognosis.

Purpose of the Study:

  • To analyze the clinical characteristics, treatment, and outcomes of children with presumed encephalitis associated with SE.
  • To identify factors predicting mortality and long-term neurological deficits in this patient population.

Main Methods:

  • Retrospective review of pediatric intensive care unit cases of SE-related presumed encephalitis (February 2002 - June 2006).
  • Evaluation of patient demographics, clinical symptoms, seizure types, SE/RSE status, EEG findings, neuroimaging, CSF analysis, and outcomes.
  • Follow-up duration ranged from 6 to 51 months.

Main Results:

  • 46 children (8 months - 16 years) were analyzed; 43.4% developed RSE.
  • Common symptoms included fever (100%), upper respiratory symptoms (56.5%), and altered consciousness (45.6%).
  • Outcomes were poor: in the SE group, 4 died and 16 had long-term deficits; in the RSE group, 6 died and 13 had deficits, with no RSE survivors returning to baseline.

Conclusions:

  • SE-related presumed encephalitis in children is associated with high mortality and significant morbidity.
  • The presence of RSE and multifocal or generalized initial EEG abnormalities are critical predictors of poor outcomes.
  • Survivors were discharged on antiepileptic medications, highlighting the need for aggressive management.
Abstract

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