Aborted and refractory status epilepticus in children: A comparative analysis

Early predictors of status epilepticus-associated mortality and morbidity in children

“…Old age is an established risk factor for SE-associated mortality and morbidity in adults [9,10], primarily owing to the age-dependence of the etiology, considering that most SE episodes in the elderly are due to acute CNS insults, which are generally associated with poor outcomes. In contrast, studies on pediatric SE have indicated that young age is a risk factor for SE-associated mortality and morbidity [6,[11][12][13][14]. In fact, 15 of the 16 patients with poor outcomes in our study were 624 months old, which was consistent with the finding of another study [12] in which infants and young children were reported as more susceptible to acute systemic or CNS insults, including bacterial meningitis, encephalitis, septic shock, and head trauma.…”

“…It is not surprising that seizure intractability was related to SE-associated mortality and morbidity [10,14]. Lambrechtsen et al [14] studied refractory SE in children, which was identical to seizure intractability (failure of the second anticonvulsive drug) in this study, and reported that in-hospital mortality and long-term morbidity were significantly higher in refractory SE than in aborted SE. They also found that predictors of poor outcome were young age (<5 years), long seizure duration, and acute symptomatic etiology [14].…”

Electrographic seizures in pediatric ICU patients

“…15,27 A number of single-center studies have demonstrated an association between electrographic seizures or electrographic status epilepticus and worse outcome in critically ill children. 11,12,14,16,17,28 Our data also indicate that electrographic status epilepticus was associated with higher mortality, even after adjusting for the neurologic diagnosis category and initial EEG background category. However, the current data cannot establish whether electrographic status epilepticus is a modifiable risk factor for mortality or is a nonmodifiable biomarker of severe brain injury leading to mortality.…”

“…Data obtained from CEEG reportedly affect clinical management in 59% of monitored children, most often by affecting anticonvulsant utilization. 15 Several studies have reported an association between electrographic seizures or status epilepticus and worse outcome, 11,12,16,17 occurring independently of potential confounders related to acute etiology and critical illness severity.…”

Status Epilepticus in the PICU: Quieting the Storm

“…Increased morbidity can be associated with increased duration of seizures [67], however in some series this is only for acute symptomatic etiologies [68]. This is consistent with high rates of mortality (30 %) [69], and resultant epilepsy (100 %) [70], in some series of severe prolonged pediatric RSE [71], especially for acute symptomatic etiologies. Overall 11-16 % at 1 year and 18 % at 2 years will have a recurrence of SE [26,72], but recurring especially in those patients who were not neurologically normal at baseline [72].…”