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Course and Outcome of Children with Convulsive Status Epilepticus Admitted to a Pediatric Intensive Care Unit

Madhuradhar Chegondi1, Mary M Garland2, Prithvi Sendi3

  • 1Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa, USA.

Cureus
|June 29, 2019
PubMed

Insights

In children with convulsive status epilepticus, sub-therapeutic anti-epileptic drug levels were frequent in those with known seizure disorders. Outcomes were similar between new-onset and known seizure groups.

Area of Science:

  • Pediatric Neurology
  • Epileptology

Background:

  • Convulsive status epilepticus (CSE) is a neurological emergency in children.
  • Understanding CSE course and outcomes is crucial for effective management.
  • Differentiating between new-onset and known seizure disorders can inform treatment strategies.

Purpose of the Study:

  • To describe the clinical course and outcomes of pediatric CSE.
  • To compare outcomes between children with new-onset seizures and those with known seizure disorders.

Main Methods:

  • Retrospective, single-center study of children admitted to a pediatric intensive care unit with CSE.
  • Review of medical records for demographic and seizure-related variables.
  • Comparison of outcomes between new-onset and known seizure groups.

Main Results:

  • Out of 139 children with CSE, 69.7% had a known seizure disorder.
  • Children with new-onset seizures were younger and underwent more EEG and neuroimaging.
  • Abnormal EEG findings were more prevalent in the known seizure disorder group (p < 0.001).
  • Sub-therapeutic anti-epileptic drug levels were common in the known seizure disorder group.
  • No significant differences were observed in gender, race, insurance, seizure type, intubation, length of stay, or mortality between groups.

Conclusions:

  • Sub-therapeutic anti-epileptic drug levels are a common issue in children with known seizure disorders experiencing CSE.
  • Clinical outcomes, including mortality, are comparable between new-onset and known seizure groups with CSE.
  • Further research into optimizing anti-epileptic drug management in known epilepsy populations is warranted.

Keywords:
childrenoutcomepediatric intensive care unitstatus epilepticus

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