Comparison of risk factors for pediatric convulsive status epilepticus when defined as seizures ≥ 5 min versus
Iván Sánchez Fernández1, Jacquelyn Klehm2, Sookee An2
1Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Child Neurology, Hospital Sant Joan de Déu, Universidad de Barcelona, Passeig Sant Joan de Déu s/n, 08950 Esplugues de Llobregat, Barcelona, Spain.
Insights
Identifying risk factors for pediatric convulsive status epilepticus (SE) shows similar predictors whether defined as seizures lasting 5 minutes (SE5) or 30 minutes (SE30). Key risk factors include younger age, prior antiepileptic drug use, and developmental delay.
Area of Science:
- Pediatric Neurology
- Epilepsy Research
- Clinical Medicine
Background:
- Pediatric convulsive status epilepticus (SE) is a medical emergency.
- Defining SE duration is crucial for accurate risk factor identification.
Purpose of the Study:
- To identify risk factors (RF) for pediatric convulsive SE.
- To determine if defining SE as seizures ≥ 5 minutes (SE5) or ≥ 30 minutes (SE30) alters identified RF.
Main Methods:
- Retrospective case-control study.
- Included patients aged 1 month to 21 years with convulsive SE.
- Compared SE cases with controls using SE5 and SE30 thresholds.
Main Results:
- 1062 patients were enrolled; 444 had SE5, 149 had SE30.
- Risk factors for SE were similar for both 5-min and 30-min thresholds.
- Patients with SE were younger, used more antiepileptic drugs (AEDs), had developmental delay, and higher mortality.
Conclusions:
- Identified RF predict pediatric convulsive SE.
- RF remain consistent regardless of whether SE is defined as 5 or 30 minutes.
Purpose:
To identify risk factors (RF) of pediatric convulsive status epilepticus (SE) and to determine whether defining SE as seizures ≥ 5 min (SE5) or seizures ≥ 30 min (SE30) would modify the risk factors identified.
Methods:
Retrospective case-control study. We included patients 1 month to 21 years of age at the time of convulsive SE. We compared the characteristics of patients with SE (cases) versus those without SE (controls) using two different seizure duration thresholds: 5 min and 30 min.
Results:
1062 patients (54% males) were enrolled. The median (p25-p75) age at the episode was 6.4 (2.8-11.8) years. 444 (41.8%) patients had SE5 and 149 (14%) patients had SE30. On univariate analysis, risk factors for SE were not markedly different when considering a 5 or 30 min threshold. Compared to their respective controls patients with both SE5 and SE30 were younger at the age of seizure onset and at the age of SE, were on more antiepileptic drugs (AEDs) at baseline, had a higher rate of changes in AEDs in the three months prior to the episode, were more likely to have developmental delay at baseline, and a higher mortality rate. A higher baseline seizure frequency, and a higher increase in seizure frequency prior to the index episode were seen only in SE5.
Conclusion:
This series identifies RF which predict convulsive SE in pediatric patients. These RF are similar when considering a 5 min or a 30 min threshold for the definition of SE.
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