Clinical characteristics and prognosis in a large paediatric cohort with status epilepticus

Abstract

To describe the aetiology, clinical features, and short-term outcomes of children with status epilepticus (SE), in particular super-refractory SE (SRSE), by a nationwide multicentre study in China. Methods: In this retrospective study, inpatient children with SE were identified from neurology departments and paediatric intensive care units from 44 hospitals in 27 provinces of China between 2013 and 2015. Clinical data were exported from the Hospital Information System. Results: Clinical records from children with SE (n = 4255) aged 1 month to 18 years were enrolled; 13.1 % were diagnosed with SRSE. The most common known SE aetiology was acute symptomatic aetiology (42.8 %) and 50.2 % of SE was caused by epilepsy of unknown aetiology. Acute central nervous system (CNS) infections (38.8 %) were associated with SRSE (P < 0.001). The overall SE in-hospital mortality rate was 3.0 %, which was significantly higher in the children with SRSE than in those with non-SRSE (15.2 % versus 1.4 %, respectively; P < 0.001). Fourteen percent of the children with SE had various levels of neurological dysfunction at discharge. SRSE was a risk factor for in-hospital mortality (hazard ratio = 4.14; 95 % confidence interval [CI]: 2.34−7.32; P < 0.001) and neurological dysfunction at discharge (odds ratio = 2.85; 95 % CI: 1.90−4.27; P < 0.001). Conclusion: Acute symptomatic aetiology was the most common known cause of paediatric SE. Aetiology was associated with progression to SRSE and short-term neurological dysfunction at discharge. Furthermore, SRSE was considered a risk factor for in-hospital mortality and short-term neurological dysfunction.

Efficacy and safety of VNS therapy or continued medication management for treatment of adults with drug-resistant epilepsy: systematic review and meta-analysis

“…People with DRE experience significantly more comorbidities, including depression, seizure-related injuries, and neurological deficits than those without epilepsy or with epilepsy that responds to treatment [4,5], and have significantly higher mortality risk [6,7]. DRE is also associated with sudden unexplained death in epilepsy (SUDEP) which represents a major cause of death in this population [8][9][10].…”

Multicenter Study of the Impact of COVID-19 Shelter-In-Place on Tertiary Hospital-based Care for Pediatric Neurologic Disease

“…Infection is a risk factor for both pediatric stroke [20][21][22] and status epilepticus. 23,24 The decrease in encounters for these diagnoses could reflect an overall decrease in exposure to typical childhood viral illnesses. Additionally, common provoking factors for seizures and status epilepticus including poor sleep and medication adherence challenges could have improved when children were out of school and home with caregivers more consistently.…”

<p>Etiology of Non-Traumatic Seizures in Children Admitted to PICU: An Eight-Year Retrospective Study</p>

“…11 A nationwide multicentre study in China revealed that the most common known SE etiology was acute symptomatic etiology (42.8%) and 50.2% of SE was caused by epilepsy of unknown etiology. 12 Valencia and colleagues stated that EEG is helpful in the great majority of their patients for supporting the diagnosis of epileptic seizures. 13 The 2014-2017 period included more patients with unknown reason epilepsy (36.5%) compared to 2010-2013 (19.8%).…”