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Time Elapsed from Onset of Pediatric Convulsive Status Epilepticus to Antiepileptic Administration-An Experience of

Vaibhav Rajendra Suryawanshi1, Kavita Srivastava2, Bijoy Kumar Panda3

  • 1Department of Clinical Pharmacy, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, 411038, India.

Indian Journal of Pediatrics
|January 22, 2022
PubMed

Insights

Delays in administering antiepileptic drugs (AEDs) for pediatric convulsive status epilepticus (CSE) were observed, exceeding recommended timelines in Indian hospitals. This highlights a critical gap in timely treatment for refractory CSE (RCSE) cases.

Area of Science:

  • Pediatric Neurology
  • Emergency Medicine
  • Clinical Pharmacology

Background:

  • Pediatric convulsive status epilepticus (CSE) requires prompt treatment.
  • Standard treatment guidelines exist, but real-world adherence and timeliness in India are not well-documented.
  • Refractory CSE (RCSE) poses significant management challenges.

Purpose of the Study:

  • To evaluate the time elapsed from CSE onset to antiepileptic drug (AED) administration in Indian children.
  • To compare actual AED administration times with the 'Status Epilepticus Management Protocol'.
  • To identify delays in treatment escalation for pediatric CSE.

Main Methods:

  • Prospective observational analysis of 52 children with CSE.
  • Data collected from an urban, academic tertiary care teaching hospital.
  • Comparison of time frames for first-line, second-line, and third-line AED therapies against protocol standards.

Main Results:

  • Median time to first-line AED: 30 min; second-line: 68 min; third-line: 105 min.
  • Second dose of non-benzodiazepine AED administered at a median of 90 min.
  • Fifty percent of patients received continuous infusions; overall treatment escalation was delayed.

Conclusions:

  • Significant delays exist in AED administration and escalation for pediatric CSE in the studied Indian setting.
  • Current practices may not fully align with established 'Status Epilepticus Management Protocol' timelines.
  • Further research is needed to optimize treatment delivery for pediatric CSE and RCSE.

Keywords:
AntiepilepticsManagement-protocolPediatric convulsive status epilepticusTime elapsed

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