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Pediatric status epilepticus: identification and evaluation

Emily R Freilich1, John M Schreiber, Tesfaye Zelleke

  • 1Department of Neuroscience, Children's National Health System, Washington, District of Columbia, USA.

Current Opinion in Pediatrics
|October 15, 2014
PubMed

Insights

Status epilepticus is a growing neurologic emergency. Prompt diagnosis and evaluation, including advanced imaging and genetic testing, are crucial for effective management and treatment of this life-threatening condition in children.

Area of Science:

  • Neurology
  • Pediatric Emergency Medicine

Background:

  • Status epilepticus (SE) is an increasing neurologic emergency.
  • Evolving definitions and improved detection contribute to rising incidence.
  • Current understanding requires updates on identification and etiology.

Purpose of the Study:

  • Present the current definition of SE, including a modified operational definition.
  • Provide updates on identifying children with SE.
  • Discuss etiologic considerations and diagnostic testing rationale.

Main Methods:

  • Review of recent literature and clinical data.
  • Analysis of diagnostic modalities including MRI, CT, EEG, and genetic testing.
  • Evaluation of pediatric intensive care unit (PICU) data for electrographic seizures.

Main Results:

  • MRI demonstrates benefits over CT in new-onset SE.
  • High rates of electrographic seizures identified in unexplained acute encephalopathy.
  • Genetic testing is recommended for young children with recurrent SE.

Conclusions:

  • Early recognition and diagnostic evaluation are vital for managing SE.
  • Identifying the cause of SE may necessitate specific treatments.
  • Comprehensive evaluation may include laboratory work, neuroimaging, EEG, lumbar puncture, and genetic testing.
Abstract

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