Childhood status epilepticus: a study on its etiology, management and early outcome

ABSTRACT

Status epliepticus is a true medical urgency with high mortality. This study was surveyed etiology, management and early outcome of children with status epilepticus. Patients with status epilpeticus who admitted to emergency ward of Tabriz Children's Hospital between 1381 and 1384 were reviewed cross-sectional and analytical study on seizure type and etiology, its management and outcome at discharge from hospital. Among 123 patients with status epilepticus, 50 patients [40.7%] were afflicted with refractory status epilepticus and 73 patients [59.3%] had non - refractory status epilepticus. The most common etiologies in patients with status epilepticus in order of decreasing frequency were related to be prolonged febrile seizure [40.7%], remote symptomatic [28.4%], acute symptomatic [16.2%] and idiopathic [14.6%]. There was significant correlation between age and etiology [P=0.007]. The most common type of seizure was generalized seizure in 70.7% of patients. The median of duration of status epilepticus was 60 [37-146.25] minutes. In 28 patients [22.7%], diazepam with phenytoin or phenobarbital was used. In 40 patients [32.5%], diazepam with phenytoin and phenobarbital and in 50 patients [40.7%], midazolam were used. In 4 patients [3.25%], thiopental was used. Using midazolam, in 82% of patients with refractory status epilepticus lead to control of seizure. 85.9% of patients returned to their condition before status epilepticus. 8.26% of patients died, and in 5.7% of patients a new neurological sequel was established after status epilepticus. There was statistically significant correlation between patient's outcome and etiology of seizure [p=0.001]. The lowest rate of the mortality and morbidity was seen in prolonged febrile seizure [4%] and the most was in acute symptomatic [45%]. Prolonged febrile seizure was the most common etiology in status epilepticus. The highest mortality rate was seen in patients with acute symptomatic etiology. In most cases, intravenous midazolam infusion terminated the refractory status epilepticus