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Time to treatment in pediatric patients with repeated episodes of status epilepticus

Jennifer V Gettings1, Iván Sánchez Fernández1,2, Anne Anderson3

  • 1Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

BMC Neurology
|May 26, 2025
PubMed

Insights

Pediatric patients with repeated status epilepticus episodes did not show improved treatment times for subsequent seizures. Prior epilepsy diagnosis was the only predictor of recurrence, highlighting a need for better interventions and caregiver education.

Area of Science:

  • Neurology
  • Pediatric Epilepsy

Background:

  • Status epilepticus (SE) is a neurological emergency in children.
  • Understanding factors predicting recurrent SE is crucial for timely intervention.

Purpose of the Study:

  • To compare clinical factors in pediatric patients with recurrent SE versus single SE episodes.
  • To identify predictors of repeated status epilepticus in children.

Main Methods:

  • Retrospective analysis of a multicenter, prospective observational cohort.
  • Inclusion of pediatric patients with status epilepticus from 2011 to 2019.

Main Results:

  • 10.3% of patients experienced recurrent status epilepticus.
  • A prior epilepsy diagnosis was the sole predictor of SE recurrence.
  • No significant difference in time to benzodiazepine or non-benzodiazepine anti-seizure medication treatment for first vs. second SE episodes.
  • Caregiver treatment of out-of-hospital SE did not improve between first and second episodes, though time to benzodiazepine was faster when administered by caregivers.

Conclusions:

  • Treatment timeliness for recurrent status epilepticus in children does not improve.
  • Opportunities exist for enhanced caregiver education and intervention strategies for pediatric SE.
  • Prior epilepsy diagnosis is a key factor associated with recurrent status epilepticus.
Abstract

Keywords:
Anti-seizure medicationsBenzodiazepinesRefractory status epilepticusStatus epilepticusTreatment delay

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