Course and Outcome of Children with Convulsive Status Epilepticus Admitted to a Pediatric Intensive Care Unit

Chegondi, Madhuradhar; Garland, Mary; Sendi, Prithvi; Jayakar, Anuj; Totapally, Balagangadhar

doi:10.7759/cureus.4471

Cited by 6 publications

(9 citation statements)

References 29 publications

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“…Of the children having a generalized seizure, 95 (62%) presented with fever, 30% had vomiting, 28% had altered sensorium, 18% had meningeal signs and 11% had signs of raised intracranial tension. The most common clinical features were fever, altered sensorium, and vomiting which was consistent with the finding in western Nepal and east and south India [16][17][18][19]. About 95% of cases presented generalized seizure with an abnormal EEG, 80% of the partial seizure cases had abnormal EEG.…”

Section: Discussionsupporting

confidence: 85%

Hospital-Based Prevalence, Electroencephalogram (EEG), and Neuroimaging Correlation in Seizures Among Children in Odisha, India

Das¹,

Paramita²,

Swain³

et al. 2022

Cureus

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Background: Febrile seizures are very common in pediatric practice. We need to differentiate between febrile seizures and other seizures due to central nervous system (CNS) infection by various means of investigation. Though approximately 30% of patients with febrile seizure have later epilepsy and the risk is around 20% even if electroencephalogram (EEG), and neuro-imagings are normal. But data regarding this is laking in developing countries like India.Aim: The primary objective of this study is to determine the hospital-based prevalence among various types and etiologies of seizures in children admitted to the pediatric department in a teaching hospital of a developing country, India. Besides, the different types of seizures were correlated with the EEG and neuroimaging findings along with the acute onset of seizures among children. Conclusion:The study concluded that EEG must be the standard modality of test for patients' diagnosis of seizure in children with seizures. CT/MRI scan can give a better supplement to the results but MRI findings are more accurate in cases of complex febrile seizures.

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Section: Discussionsupporting

confidence: 85%

Hospital-Based Prevalence, Electroencephalogram (EEG), and Neuroimaging Correlation in Seizures Among Children in Odisha, India

Das¹,

Paramita²,

Swain³

et al. 2022

Cureus

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“…21% patients in our study had pre-existing epilepsy as compared to 69.7% in a 5-year retrospective study conducted in PICU in USA [ 15 ], 36% in a similar study conducted in UK [ 11 ], 46.6% in study conducted in Delhi, India [ 12 ] and 25.7% in a study in Bihar, India [ 16 ]. It is noteworthy that almost 80% of our patients presented with 1st episode of seizure due to the differences in underlying cause and approach to management posed by it.…”

Section: Discussionmentioning

confidence: 39%

A study of critically ill children presenting with seizures regardless of seizure duration admitted in the PICU of a tertiary hospital in India

Amonkar¹,

Revathi²,

Gavhane³

2020

Epilepsy & Behavior Reports

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Our aim was to study the clinical profile, immediate outcome and risk factors associated with poor outcome in critically ill children presenting with seizures requiring PICU admission. As seizures lasting 10 min or more can potentially cause brain damage, we included all children regardless of seizure duration. The records of 157 children aged 1 month to 16 years admitted in the PICU at a tertiary hospital in India with seizures as the presenting symptom during a three-year period were studied retrospectively. Median age of patients was 4 years. 34 (21%) had pre-existing epilepsy and 33 (21%) had previous developmental delay/neuro-deficit. Seizure duration was > 30 min in 75 (47.7%) and 56 (35.6%) required the use of more than 2 antiseizure drugs. 101 (64%) had acute symptomatic seizures, 28 (17%) remote symptomatic and 27 (17.1%) had unknown cause. New onset neurological deficit was seen in 18 (15.6%) and 14 (8.9%) died. Young age, high PEWS score at presentation, prolonged/recurrent seizures, CNS infection, need for multiple antiseizure drugs and ventilation/pressor use were risk factors for poor outcome. Neurological outcome and survival of children in our study were good. Further all-inclusive studies irrespective of seizure duration are needed to obtain a complete picture of critical children presenting with seizures.

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“…Similar to the results of previous studies, sex was not a determining factor despite the higher percentage of males in our study population (female-to-male ratio, 1:1.15) (27,28) . Previous reports on SE included patients ranging in age from 1 to 6.5 years (25,28,29) , whereas the median age of SE children in our study was 59 months (IQR, 22-115 months). In the group with febrile SE, the median age was lower, 40 months.…”

Section: Discussionmentioning

confidence: 85%

The predictive factors for prolonged seizures and status epilepticus: a single center study

Ayanoğlu¹,

Ongun²

2021

BMJ

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Objectives: To analyze the clinical features of prolonged seizures and status epilepticus and perform risk analysis on super refractory status epilepticus (SRSE) in pediatric intensive care unit (PICU) admissions. Method: Demographic features, underlying etiologies, treatment modalities, electroencephalographic and neuroimaging outcome of intensive care unit admissions between 2015 and 2019 were analyzed. Results: Seventy-one children were enrolled. The common etiology for prolonged seizure was fever in 45.1% of the children (central nervous system infection: 16.9%, infection other than central nervous system: 28.2%), withdrawal of the antiepileptic medication in 40.9%, intoxications in 12.7% of the children and intracranial hemorrhage due to arteriovenous malformation in one (1.4%) patient. Initial diagnostics exhibited 23.9% of hypoglycemia, 18.3% of hypocalcemia, 15.5% of hyponatremia, 35.2% of acidosis, and 25.4% of elevated lactate. Group categorizations were based on fever and new onset of seizure. Approximately 45.1% of the population acquired fever at the onset and consisted of younger children compared to their counterparts (p=0.023). Children with pre-existing epilepsy had frequent history of sibling death, while patients with new-onset of seizure possessed significant lactate elevations, acidosis, and required mechanical ventilation more often (p=0.002, p=0.008, p=0.017). Twelve (16.9%) patients developed SRSE. Low serum sodium and calcium levels were associated with developing SRSE (OR: 10.800, 95%CI: 2.518-46.318; OR: 4.554, 95%CI: 1.159-17.892); however PRISM-3 score has been identified the single independent risk factor in children proceeding to SRSE (OR: 1.174, 95% CI: 1.039-1.327). Three (4.2%) children died of secondary complications. Tracheostomy cannulation was performed in two (16.7%) SRSE patients due to neurological incapability to maintain a patent airway. Conclusion: PRISM-3 score is the independent risk factor of SRSE. Electrolyte abnormalities (hyponatremia and hypocalcemia) are associated with developing SRSE.

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Course and Outcome of Children with Convulsive Status Epilepticus Admitted to a Pediatric Intensive Care Unit

Cited by 6 publications

References 29 publications

Hospital-Based Prevalence, Electroencephalogram (EEG), and Neuroimaging Correlation in Seizures Among Children in Odisha, India

Hospital-Based Prevalence, Electroencephalogram (EEG), and Neuroimaging Correlation in Seizures Among Children in Odisha, India

A study of critically ill children presenting with seizures regardless of seizure duration admitted in the PICU of a tertiary hospital in India

The predictive factors for prolonged seizures and status epilepticus: a single center study

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