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Risk Factors for Acute Symptomatic Seizure in Bacterial Meningitis in Children
Ana Rosa Melo Corrêa-Lima1, Demócrito de Barros Miranda-Filho2, Marcelo Moraes Valença3
1Department of Neurology, University of Pernambuco, Recife, Brazil anarosamclima@hotmail.com.
Journal of Child Neurology
|November 13, 2014
Summary
In children with bacterial meningitis, seizures are predicted by younger age, pneumococcal cause, altered mental status, and low cerebrospinal fluid white blood cell counts. In-hospital seizures significantly increase mortality risk.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Bacterial meningitis is a serious infection in children.
- In-hospital seizures are a known complication.
- Predictors of seizures in this population require further investigation.
Purpose of the Study:
- To identify clinical and laboratory predictors of in-hospital seizures in children with acute bacterial meningitis.
- To assess the association between admission parameters and seizure occurrence.
- To evaluate the impact of seizures on mortality.
Main Methods:
- Retrospective case-control study.
- Involved 270 children (1 month to 14 years) with confirmed bacterial meningitis.
- Stepwise multiple logistic regression analysis was used to identify independent predictors.
Main Results:
- Younger age (<2 years), pneumococcal etiology, altered mental status, and cerebrospinal fluid leukocyte count <1000 cells were independent predictors of in-hospital seizures.
- The incidence of in-hospital seizures was 24.8% (67/270).
- Mortality was significantly higher in children with seizures (37.3%) compared to those without (4.43%).
Conclusions:
- Clinical and laboratory findings at admission can predict in-hospital seizures in pediatric bacterial meningitis.
- Pneumococcal meningitis and altered mental status are significant risk factors.
- Prompt recognition and management of these risk factors may be crucial for improving outcomes and reducing mortality.
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