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Outcomes following electrographic seizures and electrographic status epilepticus in the pediatric and neonatal ICUs

Elana F Pinchefsky1, Cecil D Hahn

  • 1aDivision of Neurology, The Hospital for Sick Children bDepartment of Paediatrics, University of Toronto, Toronto, Ontario, Canada.

Current Opinion in Neurology
|January 25, 2017
PubMed

Insights

Electrographic seizures in critically ill children and neonates are linked to poorer neurological outcomes. Lower seizure burden thresholds indicate increased risk, necessitating further research into early treatment efficacy.

Area of Science:

  • Neonatal and pediatric neurology
  • Critical care medicine
  • Clinical neurophysiology

Background:

  • Electrographic seizures and status epilepticus are increasingly recognized in critically ill neonates and children.
  • Understanding their impact on neurological outcomes is crucial for guiding management.

Purpose of the Study:

  • To review the association between seizure burden and neurological outcomes in critically ill neonates and children.
  • To evaluate the effectiveness of electroencephalography-targeted therapy in reducing seizure burden and improving outcomes.

Main Methods:

  • Review of recent studies investigating seizure burden and neurological outcomes in pediatric populations.
  • Analysis of randomized controlled trials on electroencephalography-targeted therapy in neonates.

Main Results:

  • An independent association exists between increased seizure burden and worse short-term and long-term outcomes in children and neonates.
  • A seizure burden threshold of 12-13/min/h is associated with increased risk of adverse neurological outcomes, lower than the conventional definition of status epilepticus.
  • Electroencephalography-targeted therapy can reduce seizure burden in neonates, but larger trials are needed to confirm outcome improvement.

Conclusions:

  • Mounting evidence links higher seizure burden to worse neurological outcomes in critically ill children and neonates.
  • Further research is required to determine if early seizure identification and aggressive treatment improve neurodevelopmental outcomes.
Abstract

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