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Status epilepticus in children with epilepsy: Dutch study of epilepsy in childhood

Hans Stroink1, Ada T Geerts1, Cees A Van Donselaar1

  • 1Department of Neurology, St. Elisabeth Hospital and TweeSteden Hospital, TilburgDepartment of Pediatric Neurology, Erasmus MC/Sophia Children's Hospital, RotterdamDepartment of Neurology, Medical Center Rijnmond-South, RotterdamDepartment of Pediatric Neurology, University Medical Center, UtrechtDepartment of Pediatric Neurology, University Medical Center, GroningenDepartment of Pediatric Neurology, Juliana Children's Hospital, The Hague, The Netherlands.

Epilepsia
|July 27, 2007
PubMed

Insights

Status epilepticus (SE) in children with epilepsy does not significantly worsen outcomes or mortality. However, SE indicates underlying disease severity and is linked to poorer prognosis, especially when occurring after initial diagnosis.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Neuroscience

Background:

  • Status epilepticus (SE) is a critical neurological emergency.
  • Understanding the long-term course and outcomes of epilepsy following SE in children is crucial for prognosis.
  • The presenting sign or occurrence during the course of epilepsy may influence outcomes.

Purpose of the Study:

  • To investigate the course and outcome of epilepsy in children who experienced status epilepticus (SE).
  • To compare outcomes for children with SE as a presenting sign versus those with SE after epilepsy diagnosis.
  • To identify factors influencing prognosis in pediatric epilepsy with SE.

Main Methods:

  • Prospective follow-up of 494 children (1 month–15 years) with newly diagnosed epilepsy for 5 years.
  • Analysis of outcomes, including terminal remission and intractable epilepsy, for children with and without SE.
  • Identification of independent factors associated with SE at presentation and during the course of epilepsy.

Main Results:

  • Of 494 children, 47 experienced SE; 41 had SE at diagnosis, with 32 experiencing it as their first seizure.
  • Terminal remission at 5 years was not significantly worse for children with SE at presentation (31.7% vs. 21.2%).
  • SE recurrence occurred in 32% of children with SE at diagnosis; children with SE after diagnosis had a worse prognosis.

Conclusions:

  • While SE at presentation doesn't significantly worsen epilepsy outcomes or mortality, it indicates underlying disease severity.
  • Children experiencing SE during their epilepsy course face a worse prognosis and higher SE recurrence rates.
  • Etiology and epilepsy type are key prognostic factors, with SE often being an indicator of disease severity.
Abstract

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