Etiology and outcomes of convulsive status epilepticus in children
Muhammad Uzair1, Asif Ibrahim2, Faisal Zafar3
1Dr. Muhammad Uzair MBBS, FCPS (Pediatrics), Fellow Pediatrics Neurology, Department of Pediatric Neurology, Children Hospital Lahore, Pakistan.
Insights
Acute symptomatic causes of pediatric convulsive status epilepticus are common and linked to worse outcomes. This study highlights the need for timely intervention and management strategies for better patient recovery.
Area of Science:
- Pediatric Neurology
- Epileptology
- Critical Care Medicine
Background:
- Convulsive status epilepticus (CSE) is a neurological emergency in children.
- Understanding the diverse etiologies and outcomes of CSE is crucial for effective management.
Purpose of the Study:
- To investigate the various causes of CSE in pediatric patients.
- To analyze the associated outcomes, including recovery, morbidity, and mortality.
Main Methods:
- A prospective study of 73 pediatric patients presenting with CSE from January 2018 to June 2018.
- Data collection included etiological factors and patient outcomes.
- Statistical analysis was performed to determine significant associations.
Main Results:
- Acute symptomatic etiology (34%) was the most frequent cause of CSE.
- CSE was controlled within one hour in 57% of patients.
- Mortality was 22%, with 10.9% of deaths linked to acute symptomatic causes.
Conclusions:
- Acute symptomatic etiology is a predominant cause of pediatric CSE.
- CSE associated with acute symptomatic causes has a poorer prognosis and higher mortality rates.
Objective:
The study aimed to ascertain different causes and outcomes of convulsive status epilepticus in children.
Methods:
From January 2018 to June 2018, seventy three patients who presented with status epilepticus were studied. Data were recorded with the help of a pre-formed performa. Etiological factors and outcomes in terms of recovery, morbidity and mortality were studied.
Results:
Out of 73 children, forty one (56%) were males and 32(44%) were females with median age of 1.09±0.27 years. Etiologies were acute symptomatic 25(34%), febrile 19(26%), progressive encephalopathy 10(14%), remote symptomatic 10(14%) and idiopathic 7 (9%) with p-value 0.005. Status epilepticus was controlled within one hour in 42(57%), within 1-6 hours in 21(29%) and more than 6 hours in 10(14%) patients with p-value 0.027. During hospitals stay, twenty one (29%) patients recovered completely, seizure recurred in 12(16%), Twelve (16%) became mentally retarded, Twelve (16%) developed mental retardation along with seizures and 16(22%) died. Eight (10.9%) deaths were attributed to acute symptomatic etiology with p-value less than 0.001.
Conclusion:
This study concluded that acute symptomatic etiology was more common cause of status epilepticus as compared to other etiologies and it is associated with poorer outcomes as compared to other etiologies.
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