Related Experiment Video
Updated: Oct 31, 2025
Long-term Continuous EEG Monitoring in Small Rodent Models of Human Disease Using the Epoch Wireless Transmitter System
Published on: July 21, 2015
Compliance with status epilepticus management protocol and effect on clinical outcomes in children with status
Kavita Srivastava1, Vaibhav Rajendra Suryawanshi2, Naveen Yerrapalam2
1Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Pune, Maharashtra, India.
Insights
Adhering to the Status Epilepticus Management Protocol, particularly within timeframes, is crucial for pediatric patients. Non-compliance significantly impacts hospital stay, seizure duration, and recovery, highlighting the need for improved pre-hospital rescue therapy.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Emergency Medicine
Background:
- Status epilepticus (SE) management guidelines exist, but literature on antiepileptic drug (AED) use and treatment compliance is limited.
- Optimizing SE treatment is essential for better clinical outcomes in pediatric patients.
Purpose of the Study:
- To evaluate the utilization of antiepileptic drugs in children experiencing status epilepticus.
- To analyze the impact of adherence to the Status Epilepticus Management Protocol on clinical outcomes in pediatric SE.
Main Methods:
- An 8-month prospective observational study in a tertiary care hospital involving children (1 month to 14 years) with SE.
- Assessed compliance with the hospital's SE Management Protocol regarding AEDs, administration sequence, and timing.
- Compared clinical outcomes (hospital stay, intubation, refractory SE, seizure duration, functional deficits) between compliant and non-compliant groups.
Main Results:
- 40 pediatric patients with SE were studied; 60% showed compliance with the SE Management Protocol.
- Non-compliance with treatment timeframes significantly prolonged hospital stay (9 vs. 4 days) and SE duration (115 vs. 50 min).
- Compliant patients had a higher rate of return to functional baseline at discharge (79% vs. 44%).
Conclusions:
- Full compliance was observed for AED choice and sequence, but adherence to timeframes was critical.
- Non-compliance within treatment timeframes significantly worsened hospital stay, SE duration, and clinical outcomes.
- Attention is needed to improve pre-hospital rescue therapy for pediatric status epilepticus.
Background:
Guidelines for the management of status epilepticus (SE) aid in rationalising the treatment for a better clinical outcome; however, published literature regarding the use of antiepileptics and compliance is limited, even after the availability of a consensus guideline.
Objectives:
To evaluate the use of antiepileptics in children with SE and to analyse the effect of compliance with the Status Epilepticus Management Protocol on clinical outcomes.
Methods:
An open-label non-randomised prospective observational study was conducted in children with SE aged 1 month to 14 years for 8 months in a tertiary care teaching hospital. The recommended antiepileptics, sequence of drug administration and time frames of management offered to paediatric patients were assessed for compliance with the Status Epilepticus Management Protocol adopted in our hospital. Comparison of clinical outcomes (hospital stay, intubation, refractory and super-refractory SE, duration of SE cessation, functional motor deficits and cognitive decline) between compliant and non-compliant patients was assessed.
Results:
A total of 40 patients were included in the study, of which 28 (70%) were boys. All the patients received midazolam nasal spray in the triage area. Only 18% of the patients received rescue benzodiazepine (BZD) antiepileptic drug (AED) therapy in pre-hospital settings. Median time (p25-p75) of administration of first-line AED (BZD) and second-line AED (non-BZD) was 11 (8-15) min and 30 (22-35) min, respectively. Administration of continuous infusion (IV midazolam) was delayed at 57 (45-69) min. Compliance with the Status Epilepticus Management Protocol was seen in 24 (60%) patients. Non-compliance with the treatment protocol in relation to the time frame significantly prolonged the length of hospital stay (9 vs 4 days, p=0.0008) and SE duration from first assessment (115 vs 50 min; p=0.005). At discharge, the proportion of patients returning to their functional baseline was significantly different in the compliant and non-compliant patient groups (79% vs 44%). There were no deaths.
Conclusion:
Rescue therapy in the pre-hospital setting needs attention. There was full compliance with the Status Epilepticus Management Protocol for choice of AED and sequence of AED therapy. Non-compliance in treatment management within time frames significantly affected the length of hospital stay, duration of SE and clinical outcome.
More Related Videos
04:51Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
08:28Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
Published on: April 5, 2011
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management