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Nonconvulsive seizures are common in critically ill children

N S Abend1, A M Gutierrez-Colina, A A Topjian

  • 1Division of Neurology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd., Philadelphia, PA 19104, USA. abend@email.chop.edu

Neurology
|February 11, 2011
PubMed

Insights

Nonconvulsive seizures are common in critically ill children with acute encephalopathy. Younger age was the only identified clinical risk factor, highlighting the need for further research to optimize seizure detection and management.

Area of Science:

  • Pediatric critical care medicine
  • Neuroscience
  • Clinical electroencephalography (EEG)

Background:

  • Retrospective studies suggest nonconvulsive seizures (NCS) occur in critically ill children.
  • Prospective data on NCS incidence and risk factors in this population are limited.

Purpose of the Study:

  • To prospectively determine the incidence of NCS in critically ill children.
  • To identify clinical risk factors for NCS in this population.
  • To evaluate EEG monitoring detection times for NCS.

Main Methods:

  • Continuous EEG monitoring was performed on 100 critically ill children (non-neonates) with acute encephalopathy.
  • Prospective enrollment and data collection were employed.
  • Logistic regression analysis identified risk factors for seizure occurrence.

Main Results:

  • Electrographic seizures occurred in 46% of children; status epilepticus in 19%.
  • NCS were exclusively diagnosed in 32% of patients.
  • Younger age was the sole clinical risk factor for seizures (p=0.03).
  • Seizure detection occurred within 24 hours in 87% of cases, with 52% detected in the first hour.

Conclusions:

  • NCS are prevalent in critically ill children with acute encephalopathy.
  • Clinical features offer limited predictive value for seizure risk.
  • Further research is required to identify high-risk populations for optimal resource allocation and to assess the impact of seizure detection and management on outcomes.
Abstract

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