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Adverse outcomes following convulsive status epilepticus in children: relationship with hippocampal injury

Rod C Scott1

  • 1UCL Institute of Child Health, Great Ormond Street Hospital NHS Trust, London, United Kingdom. rscott@ich.ucl.ac.uk

Epilepsia
|July 13, 2010
PubMed

Insights

Pediatric convulsive status epilepticus (CSE) is a critical neurologic emergency. While etiology is the main outcome predictor, CSE may cause acute hippocampal injury, requiring further study for clinical relevance.

Area of Science:

  • Pediatric Neurology
  • Neuroscience
  • Epileptology

Background:

  • Convulsive status epilepticus (CSE) is a frequent pediatric neurologic emergency.
  • CSE is linked to substantial mortality and morbidity, with wide-ranging outcome estimates.
  • Etiology is the primary determinant of outcomes post-CSE, more so than seizure characteristics.

Purpose of the Study:

  • To investigate the relationship between CSE and hippocampal injury in children.
  • To explore the potential of CSE to cause acute hippocampal abnormalities.
  • To determine if acute findings predict later mesial temporal sclerosis and temporal lobe epilepsy.

Main Methods:

  • Review of existing literature and prospective human studies.
  • Analysis of established animal models of CSE.
  • Correlation of CSE characteristics with hippocampal injury and long-term epilepsy development.

Main Results:

  • A strong link between CSE and hippocampal injury is established in animal models.
  • Prospective human studies suggest CSE, especially prolonged febrile seizures, can induce acute hippocampal abnormalities.
  • Seizure duration and type are poor predictors of CSE outcomes.

Conclusions:

  • CSE poses significant risks in childhood neurology.
  • Acute hippocampal abnormalities following CSE are suggested in humans, but clinical relevance needs further investigation.
  • The predictive value of these acute findings for developing mesial temporal sclerosis requires additional research.

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