DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20171690

A study of the etiology and short term outcome of status epilepticus in children

Tamil Selvan, Nagaraj M. V., Saravanan P., Mrigender Nath Tudu

Abstract


Background: Convulsive status epilepticus is the most common childhood medical neurological emergency, and is associated with significant morbidity and mortality. Most data for this disorder are from mainly adult populations and might not be relevant to childhood. This study was done to obtain a uniquely paediatric perspective. The objective of the study was to the etiology and short term outcome of patients admitted with status epilepticus between the age group 1 month to 12 years at a medical college hospital.

Methods: Study design: Prospective descriptive study. Study Place: Department of Paediatrics, SIMS and RC, Bangalore, India. Study population: All children in the age group of 1 month to 12 years admitted with status epilepticus. Sample size:66. Study period: From January 2016 to December 2016.

Results: Prevalence of status epilepticus among children admitted in this study was 8.7%. Most common age was found to be 1-3 years (54.5%). Preponderance of male (51.5%) over female (48.5%) was observed. The two most common etiology observed was Atypical febrile seizures (33.3%) and meningitis (22.7%). 57.5% children presented as first episode of seizure and duration of seizure was less than 2 hours in 65.1%.

In our study, short term mortality rate was found to be 3% and morbidity was found to be 9% and meningitis was responsible for all the deaths. The mortality and morbidity in the form of neurodeficits were observed between the age group of 1 month to 3 years. Based on the duration of seizure lasting more than 8 hours, two third had mortality and one third had morbidity.

Conclusions: Status epilepticus is a severe life threatening emergency with substantial morbidity and mortality. Major causes were due to atypical febrile seizure and meningitis. Patients with younger age, male sex and seizures lasting longer duration had higher mortality and morbidity, predicting the poor outcome. 


Keywords


Atypical febrile seizures, Meningitis, Status epilepticus

Full Text:

PDF

References


Shinar S, Berg AT, Moshe SL, O’Dell C, Alemany M, Newstein D. et al. The risk of seizure recurrence after a first unprovoked afebrile seizure in childhood: an extended follow-up. Pediatr. 1996;98:216-25.

Hauser AW. Status epilepticus. Frequency, etiology, and neurological sequelae. Adv Neurol. 1983;34:3-14.

Maytal J, Shinnar S, Moshe SL, and Alvarez LA. Low morbidity and mortality of status epilepticus in children. Pediatr. 1989;83:323-33.

Chin RF, Neville BG, Peckham, Bedford H, Wade, A, Scoot RC et al. Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. Lancet. 2006;368:222-9.

Raspall-Chaure M, Chin RF, Neville BG, and Scott RC. Outcome of paediatric convulsive status epilepticus: a systematic review. Neurol. 2006;5:769-79.

Trinka E, Höfler J, Zerbs A. Causes of status epilepticus. Epilepsia. 2012;53(4):127-38.

Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol. Brain. 2011;134:28021.

De Lorenzo RJ, Garnet L, Towne AR, Waterhouse, EJ, Boggs JG, Morton L et al. Comparison of status epilepticus with prolonged seizure episodes lasting from 10 to 29 minutes. Epilepsia. 1999;40:164-9.

Cherian A, Thomas SV. Status epilepticus. Ann Indian Acad Neurol. 2009;12:140-53.

Kalita J, Nair PP, Misra UK. A clinical, radiological and outcome study of status epilepticus from India. J Neurol. 2010;257:224-9.

Lowenstein DH, Bleck T, Macdonald RL. It's time to revise the definition of status epilepticus. Epilepsia. 1999;40:120.

Walker MC. The epidemiology and management of status epilepticus. Curr Opin Neuro.11998;11:149-54.

Khurana DS. Treatment of status epilepticus, Ind J Pediatr. 2000;67;1:80-7.

Phillips SA, Shanahan RJ. Etiology and mortality of status epilepticus in children a recent update. Arch Neuro. 1989;46(1):74-6.

Kariuki SM, Mwesige AK. Prevalence and factors associated with convulsive status epilepticus in Africans with epilepsy. Neurol. 2015;84(18):1838-45.

Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA. Incidence of status epilepticus in Rochester, Minnesota.1965-1984. Neurol. 1998;50:735-41.

Wilmshurst JM, Badoe E, Wammanda RD, Mallewa M, Kakooza-Mwesige A. Child neurology services in Africa. J Child Neurol. 2011;26:1555-63.

Akpan MU, Nyong EE, Abasiubong. Pre-hospital treatment and outcome of status epilepticus in children in Nigeria. Case Study Case Rep. 2011;1:82-91.

Hussain N, Appleton R, Thorburn K. Aetiology, course and outcome of children admitted to paediatric intensive care with convulsive status epilepticus: A retrospective 5-year review. European journal of epilepsy. 2007;16(4):305-12.

DeLorenzo R, Towne A, Pellock J and Ko D. Status epilepticus in children, adults and the elderly. Epilepsiu. 1992;33(4):15-25.

Aicardia J and Chevrie J. Convulsive status epilepticus in infants and children. A study of 239 cases. Epilepsia. 1970;11:187-97.

Maytal J, Shinnar S, Moshb S. and Alvarez L. Low morbidity and mortality of status epilepticus in children. Pediatrics. 1989;83:323-31.

Hauser WA, Anderson VE, Loewenson RB, McRoberts SM. Seizure recurrence after a first unprovoked seizure. N Engl J Med. 1982;307(9):522-8.

Kang DC, Lee YM, Lee JS, Kim HD, and Coe ed CJ. Prognostic Factors of Status Epilepticus in Children. 1982;307:522-8.

Mwangi I, baerkley J, Lowe B, Peshu N, Marsh K , Newton CR .Acute bacterial meningitis in children admitted to rural kenyan hospital: increasing antibitic resistance and outcome. Pediatr Infect Dis J. 2002;21(11):1042-8.

Chin RF, Neville BG, Scott RC. A systematic review of the epidemiology of status epilepticus. Eur J Neurol. 2004;11:800-10.

Kwong KL, Lee SL, Yung A, Wong VC. Status epilepticus in 37 Chinese children: aetiology and outcome. J Paediatr Child Health 1995;31:395-8.

Gulati S, Kalra V, and Sridhar MR .Status Epilepticus in Indian Children in a Tertiary Care Center. Indian J Pediatr. 2005;72(2):105-8.