ABSTRACT
Children with epilepsy have a significantly higher rate of death than the general population. The cause of premature death among epileptics is contributed by the underlying cause, coexisting neurologic compromise and the epilepsy itself. Mortality directly related to seizures in paediatric epilepsy is the subject of this review. Seizure-related deaths in epileptics arise from status epilepticus, aspiration pneumonia, as well as sudden and unexpected death in epilepsy (SUDEP). Epilepsy per se enhances the risks of accidents and suicide. Children with epilepsy who are otherwise neurologically intact and with normal neuroimaging findings have an exceedingly low risk of seizure-related death. Poor compliance to antiepileptic drugs (AED) , poor ly co nt rol led (intractable and refractory) seizures, impaired cognition, structural/ metabolic aetiology and antiepileptic drug polypharmacy tend to carry poor prognosis. Therefore, parents need to be appropriately advised about the risk of seizurerelated premature death. Early identification, compliance with AED prescription, and treatment of comorbid conditions can reduce mortality risk and improve health outcomes in children with epilepsy. Children with intractable types of epilepsy may benefit from medical marijuana and neurosurgery
Subject(s)
Child , Death , Epilepsy/mortality , Nigeria , Seizures , Status EpilepticusABSTRACT
A 14-year-old girl diagnosed with Epstein-Barr Virus encephalitis with generalized status epilepticus and cardiac arrest. The pathogenic role of Epstein-Barr Virus was identified by a polymerase chain reaction analysis of the patient's cerebrospinal fluid. Cranial computerized tomography and magnetic resonance imaging revealed no abnormalities. After being admitted to the intensive care unit, the patient exhibited progressive improvement until complete recovery from the disease. Despite the severity of the disease, the patient did not experience long-term sequelae
Subject(s)
Encephalitis , Epstein-Barr Virus Infections , Status EpilepticusABSTRACT
Objectifs: Les objectifs de ce travail sont de determiner les caracteristiques; les facteurs de gravite et les facteurs de risque de l'etat de mal epileptique (EME) chez les adultes. Methodes: Il s'agit d'une etude retrospective des cas d'EME observes dans le service Accueil-Triage-Urgences/Reanimation du Centre Hospitalier Universitaire d'Antananarivo; a l'Hopital Joseph Raseta Befelatanana; du juillet 2005 au juin 2006. Resultats: Soixante six cas d'EME sont enregistres. Ce chiffre constitue 5;28des pathologies observees dans le service ATU/R. Ce sont surtout des crises generalises (90;09des cas) qui se manifestent par des crises subintrantes avec une predominance des formes tonicocloniques. L'EME est frequemment observe chez les sujets jeunes; de sexe masculin; vers l'age de quarantaine. Les facteurs de risque observes sont la mauvaise observance therapeutique; l'alcoolisme; l'antecedent d'AVC; l'hypertension arterielle (HTA); et le retard de la prise en charge hospitaliere. Les facteurs de gravite frequemment rencontres sont les troubles neurovegetatives : la polypnee superieure a 25 cycles par minute; la desaturation en oxygene (SpO295) et la tachycardie superieure a 100 battements par minute. L'HTA et l'hyperthermie constituent des facteurs de mauvais pronostic. Grace a l'elaboration de protocole de prise en charge dans le service; le taux de mortalite est de 4;54. Conclusion: L'EME est une pathologie grave. Le pronostic des patients depend de la qualite et la precocite de la prise en charge