Status Epilepticus in Children

Abstract

Summary: For various reasons, status epilepticus in children is different than in adults. Pediatric specificities include status epilepticus epidemiology, underlying etiologies, pathophysiological mechanisms, and treatment options. Relevant data from the literature are presented for each of them, and questions remaining open for future studies on status epilepticus in childhood are listed.

Brain pathology in focal status epilepticus: evidence from experimental models

“…The majority of FSE etiologies in adults are related to acute brain injuries (such as cerebrovascular diseases, brain trauma, and infections) or progressive conditions (e.g., tumors and neurodegenerative diseases) associated with focal alterations in the brain. The most common causes of pediatric SE are fever, acute metabolic derangements, central nervous system infections, and suspected genetic causes (Abend and Loddenkemper, 2014;Zimmern and Korff, 2020). Based on several studies, it has been suggested that the underlying etiology, age of onset, and pre-existing comorbidities represent the most important determinants of prognosis and long term consequences (Alvarez et al, 2012;Helmstaedter, 2007;.…”

“…However, patients suffering from SE have a higher mortality than patients with the same underlying disease (stroke, anoxic-hypoxic encephalopathy, etc.) that do not experience a SE (Knake et al, 2006;Logroscino et al, 2008;Rossetti et al, 2007), especially in the elderly (Canas et al, 2018) and possibly in younger children (Abend and Loddenkemper, 2014;Zimmern and Korff, 2020). Clinical studies in adult patients show that transient neurophysiological impairment and cognitive/neurological decline may occur during FncSE, followed by resolution and clinical remission (Jabeen et al, 2017;Szabo et al, 2005;Verity et al, 1993).…”

Características clínicas del estado epiléptico en niños de un hospital de tercer nivel de Lima.

“…Como era de esperar las benzodiacepinas fueron utilizadas como medicamento de primera línea, respaldado por diversas guías internacionales y la propia del HCH (18,35,36). En un 19,6% (9/46) de los casos se usó a la fenitoína como primera línea, mayormente en casos en los cuales los niños llegaban en estado post-ictal.…”

“…El tratamiento de segunda línea en niños con EE sigue siendo muy discutido en la actualidad, aunque históricamente se ha preferido a la fenitoína por su disponibilidad y baja frecuencia de recurrencias; lo cual también pudo ser observado en esta investigación (15,18,36). No obstante, varios metaanálisis y ensayos clínicos reportan al ácido valproico, fosfenitoína, fenobarbital y levetiracetam como drogas con mayor eficacia y con un perfil de seguridad al menos similar o superior al de la fenitoína (13,14,37).…”

Rodent Models of Audiogenic Epilepsy: Genetic Aspects, Advantages, Current Problems and Perspectives

“…Being a life-threatening disease, epilepsy leads to a significant reduction in quality of life as well. Severe cases may be accompanied by numerous complications: seizure induced injuries, cerebral ischemia, cardiogenic shock, headaches, intellectual disability, psychosis, hallucinations, depression, and status epilepticus (prolonged seizures or series of seizures without recovery of consciousness between them) [ 1 , 2 , 3 , 4 , 5 , 6 ].…”