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Treatment Outcomes of Pediatric Status Epilepticus in a Tertiary Pediatric Intensive Care Unit
Dilek Cavusoglu1, Elif Esra Sınmaz2, Nihal Olgac Dundar3
1From the Department of Pediatric Neurology, Faculty of Medicine, Afyon Kocatepe University, Afyon.
Insights
Prompt treatment of convulsive status epilepticus in children is vital. Phenytoin demonstrated efficiency in second-line treatment, though prompt care can prevent long-term neurological complications and reduce mortality.
Area of Science:
- Pediatric Neurology
- Critical Care Medicine
- Epileptology
Background:
- Status epilepticus in children carries significant risks of death and disability.
- Timely diagnosis and effective intervention are critical for improving outcomes.
Purpose of the Study:
- To investigate the causes, clinical presentations, and treatment strategies for pediatric convulsive status epilepticus.
- To evaluate the effectiveness of different treatment lines and identify factors influencing outcomes.
Main Methods:
- Retrospective analysis of medical records from 100 pediatric intensive care unit patients.
- Statistical analysis including Fisher exact test, chi-squared test, and Spearman correlation.
Main Results:
- First-, second-, and third-line treatments successfully stopped seizures in 29%, 36%, and 35% of patients, respectively.
- Phenytoin showed notable efficacy as a second-line treatment (32.3%).
- Mortality was 10%, morbidity 14%, with higher mortality in refractory seizures and cerebral palsy; mental retardation more common in males.
Conclusions:
- Phenytoin remains an effective antiepileptic drug for status epilepticus.
- Rapid treatment initiation is key to preventing neurological sequelae and reducing mortality in pediatric status epilepticus.
Objective:
Status epilepticus is associated with high rates of morbidity and mortality; thus, early diagnosis and proper treatment are crucial. We aimed to study the etiology, clinical features, and treatment among pediatric patients with convulsive status epilepticus.
Methods:
The medical records of 100 patients were retrospectively obtained from pediatric intensive care unit. Etiology, clinical features, and treatment were interpreted by using Fisher exact test, χ2 test, and Spearman ρ correlation coefficient.
Results:
Seizures had stopped with the first-, second-, and third-line treatment in 29%, 36%, and 35% of the patients, respectively. Only phenytoin treatment was efficient; it has 32.3% rate in second-line treatment. Whereas mortality rate was 10%, morbidity rate was 14% during the follow-up. Epilepsy, hemiparesis, spastic tetraparesis, and mental retardation developed. Mortality was significantly much more in the patients with refractory seizure and cerebral palsy. Development of mental retardation was much higher in the male sex.
Conclusions:
Phenytoin is still one of the most efficient antiepileptic drugs. If the duration of status epilepticus can be shortened by prompt treatment, neurological complications may be prevented.
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