Treatment delay and the risk of prolonged status epilepticus

Eriksson, K.; Metsäranta, Piia; Auvinen, Anssi; Kuusela, Anna‐Leena; Koivikko, Matti

doi:10.1212/01.wnl.0000180959.31355.92

Cited by 147 publications

(122 citation statements)

References 10 publications

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“…The longer SE continues the less likely it will stop (7). This is the case also in infants and children; Eriksson et al have shown that SE not treated within 30 minutes of onset is more difficult to stop with antiepileptic medication (8).…”

Section: Introductionmentioning

confidence: 99%

Effective treatments of prolonged status epilepticus in developing rats

Hasson¹,

Kim²,

Moshé³

2008

Epilepsy & Behavior

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Section: Introductionmentioning

confidence: 99%

Effective treatments of prolonged status epilepticus in developing rats

Hasson¹,

Kim²,

Moshé³

2008

Epilepsy & Behavior

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“…Basic and clinical research suggest that longer-duration seizures are more treatmentresistant and are associated with a worse outcome. [17][18][19][20] However, few data are available regarding the time elapsed from SE onset to AED administration in either the prehospital or in-hospital settings.…”

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confidence: 99%

Time from convulsive status epilepticus onset to anticonvulsant administration in children

et al. 2015

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Objective: To describe the time elapsed from onset of pediatric convulsive status epilepticus (SE) to administration of antiepileptic drug (AED).Methods: This was a prospective observational cohort study performed from June 2011 to June 2013. Pediatric patients (1 month-21 years) with convulsive SE were enrolled. In order to study timing of AED administration during all stages of SE, we restricted our study population to patients who failed 2 or more AED classes or needed continuous infusions to terminate convulsive SE. Results:We enrolled 81 patients (44 male) with a median age of 3.6 years. The first, second, and third AED doses were administered at a median (p 25 -p 75 ) time of 28 (6-67) minutes, 40 (20-85) minutes, and 59 (30-120) minutes after SE onset. Considering AED classes, the initial AED was a benzodiazepine in 78 (96.3%) patients and 2 (2-3) doses of benzodiazepines were administered before switching to nonbenzodiazepine AEDs. The first and second doses of nonbenzodiazepine AEDs were administered at 69 (40-120) minutes and 120 (75-296) minutes. In the 64 patients with out-of-hospital SE onset, 40 (62.5%) patients did not receive any AED before hospital arrival. In the hospital setting, the first and second in-hospital AED doses were given at 8 (5-15) minutes and 16 (10-40) minutes after SE onset (for patients with in-hospital SE onset) or after hospital arrival (for patients with out-of-hospital SE onset). Conclusions:The time elapsed from SE onset to AED administration and escalation from one class of AED to another is delayed, both in the prehospital and in-hospital settings. Status epilepticus (SE) is one of the most common pediatric neurologic emergencies.1 It has a mortality of 0%-3% 2-7 and morbidity that includes cognitive and neurodevelopmental impairments, epilepsy, and recurrent SE.2,8-10 SE is often refractory to the initial antiepileptic drugs (AEDs), 11,12 and refractory SE is associated with poor outcome. 12 Patient age, etiology, and SE duration all affect outcome, 5,9,13 but only SE duration is a potentially modifiable factor by rapid AED treatment. By convention, the treatment of convulsive SE is a sequence of AEDs, typically

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“…K. Eriksson concluded that the association between treatment delay and response became significant after 30 minutes when this was analyzed as a single variable (p = 0.003). 8 Those cases had prehospital therapy had poor outcome 6 cases, (26.1%) than the case who didn't receive prehospital therapy 7 cases (10.9%). But this difference is not statistically significant (p >0.05).…”

Section: Discussionmentioning

confidence: 90%

Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

Thandavarayan

Ramaswamy

Bose

et al. 2017

Int J Contemp Pediatr

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Background: Status epilepticus (SE) is a paediatric and neurological medical emergency, continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Determination of immediate outcome of SE in children in a tertiary care hospital and to identify the risk factors influencing the outcome was the objectives of the present study.Methods: A study was conducted in Dept of Pediatrics, Tirunelveli Medical College Hospital among the children from 1 month to12 years of age, who had admitted for SE in hospital’s pediatric causality from October 2009 to October 2010 were selected for the study.Results: Out of 92 patients, total 87 patients completed the study and out of those 74 have recovered and 13 have died. The risk factors significantly affecting the outcome were hypoxia at the time of arrival, decompensated shock, respiratory failure requiring intubation and acidosis.Conclusions: Proper prehospital therapy, early referral, proper care while transporting, anticipitating risk factors involved, and protocol based approach uniformly at all hospital can reduce the mortality due to status epilepticus in children.

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Treatment delay and the risk of prolonged status epilepticus

Cited by 147 publications

References 10 publications

Effective treatments of prolonged status epilepticus in developing rats

Effective treatments of prolonged status epilepticus in developing rats

Time from convulsive status epilepticus onset to anticonvulsant administration in children

Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

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