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An epidemiological study of children with status epilepticus in Okayama, Japan: incidence, etiologies, and outcomes

Itsuko Nishiyama1, Yoko Ohtsuka, Toshihide Tsuda

  • 1Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Shikatacho 2-chome 5-1, Kita-ku, Okayama 700-8558, Japan.

Epilepsy Research
|July 12, 2011
PubMed

Insights

Japanese children experience status epilepticus (SE) at a higher rate than Caucasian children. Febrile SE is common, often linked to infections like exanthema subitum and influenza, which can lead to encephalitis.

Area of Science:

  • Pediatric Neurology
  • Epidemiology
  • Infectious Diseases

Background:

  • Status epilepticus (SE) is a neurological emergency with varying incidence and outcomes globally.
  • Understanding the specific epidemiology of first-ever SE episodes in pediatric populations is crucial for public health planning.
  • Etiologies of SE in children, particularly infectious causes, require detailed investigation to inform clinical management and prevention strategies.

Purpose of the Study:

  • To determine the incidence, etiologies, and outcomes of first-ever status epilepticus (SE) in Japanese children.
  • To compare the incidence of SE in Japanese children with that reported in Caucasian populations.
  • To identify key infectious triggers, such as exanthema subitum and influenza, associated with SE and subsequent neurological complications.

Main Methods:

  • An epidemiological study was conducted in Okayama City, Japan, over a three-year period (2003-2005).
  • Data were collected on 120 pediatric patients experiencing their first episode of status epilepticus.
  • Incidence rates were calculated per 100,000 population, and etiologies were categorized (febrile, acute-symptomatic, remote-symptomatic, cryptogenic/idiopathic, unclassified).

Main Results:

  • The annual incidence of SE was 42.0 per 100,000 children, with the highest rates in those under two years old.
  • Febrile SE constituted 49.2% of cases. Exanthema subitum (15.8%) and influenza (14.2%) were the most frequent infectious etiologies, with some cases associated with encephalitis/encephalopathy.
  • Long-term outcomes included epilepsy diagnosis in 28.3% of patients, and 6.7% experienced motor and/or mental disturbances post-SE, with one mortality.

Conclusions:

  • The incidence of first-ever SE in Japanese children is higher than previously reported for Caucasian children.
  • Febrile SE is a significant proportion of pediatric SE, frequently triggered by common childhood infections like exanthema subitum and influenza.
  • Infectious etiologies, particularly exanthema subitum and influenza, are critical causes of SE and associated encephalitis/encephalopathy in Japanese children.

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