Video-electroencephalogram monitoring in children with nonconvulsive status epilepticus / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the clinical features and video-electroencephalogram (VEEG) monitoring of nonconvulsive status epilepticus (NCSE) in children.Methods 1.Object of studySeventeen patients of NCSE diagnosed with Kaplan's criteria were analyzed in Children's Hospital of Fudan University between Oct.2009 and Sep.2012.2.Data analysis:Data on demographics,etiology,clinical manifestation and response to clonazepam therapy were analyzed.3.TherapiesClonazepam 0.05 mg/kg was intravenously injected twice a day.Treatment of poor efficacy patients was combined with other antiepileptic drugs.4.Therapeutic effectClinical assessment of cognitive improvement and VEEG monitoring of background activity or paroxysmal abnormalities were analyzed.Results Nine male and 8 female of 17 patients with NCSE were involved,from 11 months to ll.4-year old.The clinical attacks lasted ranging variously time from 4 hours to 3 months.Each patient had a prolonged change of consciousness,accompanied by psychological or behavioral changes.Definite medical causes were identified in 65％ (11/17 cases) of the patients.Secondary epilepsy was the dominating cause.The characteristics of ictal VEEG in NCSE generally included slow activity and focal or generalized δ or θ activity.After clonazepam treatment,the conditions of 13 patients were under complete control,in which 4 had improvement.Six cases of unknown cause were fully controlled within 72 hours after intravenous injection of clonazepam.The prognosis of CNS infection sequelae patients,metabolism disorders and brain structural damage was poor.Conclusions NCSE may present with confusion,behavioral disturbances and psychiatric conditions.The diagnosis can be made by the ictal and interictal VEEG monitoring.It is necessary to make the diagnosis and control the seizures as quickly as possible.Clonazepam is useful in NCSE.