Baseline and outcome assessment in pediatric status epilepticus
Saba Jafarpour1, Coral M Stredny1, Juan Piantino2
1Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.
Insights
Pediatric status epilepticus (SE) has low mortality but significant morbidity. Long-term outcomes, particularly quality of life and neurocognitive effects, require further high-quality research.
Area of Science:
- Pediatric neurology
- Epileptology
- Clinical outcomes research
Background:
- Status epilepticus (SE) is a neurological emergency in children.
- Understanding the short- and long-term consequences of pediatric SE is crucial for clinical management and patient well-being.
Purpose of the Study:
- To review and summarize the diverse short- and long-term outcomes following pediatric status epilepticus (SE).
- Key outcomes examined include mortality, seizure recurrence, development of subsequent epilepsy, neurocognitive deficits, neuroimaging findings, and health-related quality of life.
Main Methods:
- A systematic literature search was conducted on MEDLINE.
- Studies focusing on pediatric populations and assessing outcomes of SE were included.
- Exclusion criteria involved studies exclusively examining adult populations.
Main Results:
- Mortality rates in pediatric SE are generally low, but morbidity presents significant challenges.
- The etiology of SE is a primary factor influencing patient outcomes.
- Significant heterogeneity among studies complicates the determination of SE's net effect on outcomes.
- Health-related quality of life (QoL) in pediatric SE is an under-researched but critical aspect of long-term outcomes.
Conclusions:
- There is a pressing need for high-quality, longitudinal data on pediatric SE outcomes.
- Future research should prioritize evaluating quality of life (QoL), neuroimaging changes, the use of continuous infusions, and cognitive/behavioral outcomes in children post-SE.
Purpose:
To summarize different aspects of short and long-term outcomes associated with SE, including mortality, recurrence, subsequent epilepsy, neurocognitive dysfunction, imaging abnormalities, and health-related quality of life.
Methods:
We searched MEDLINE for studies that assessed the short-term and long-term outcome of status epilepticus in pediatric population, including mortality, recurrence of seizure and status epilepticus, neurological, cognitive, or behavioral impairment, and health-related quality of life. We excluded studies that exclusively assessed the adult population.
Results:
Mortality in pediatric SE is relatively low, while morbidity poses more challenges. The underlying cause of SE has been shown to be a major determinant in the outcome after SE. However, it is difficult to establish the net effect of SE on outcome due to the heterogeneity of the studies. Notably, this review highlights that health-related quality of life, an important aspect of long-term outcome in pediatric SE, is under-addressed and merits further investigation.
Conclusion:
There is a need to acquire high-quality long-term data evaluating QoL, neuroimaging, use of continuous infusions, and cognitive and behavioral outcome of children who experience SE.
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