Convulsive Status Epilepticus in Children: A Prospective Observational Study from India

Abstract

Convulsive status epilepticus (CSE) is one of the commonest and life threatening pediatric neurological emergencies. Only few studies on pediatric status epilepticus (SE) are available from the Indian subcontinent. The aim was to study the etiology and immediate outcome of CSE in children getting admitted in pediatric emergency during the study period and to study association of various clinical presentations with immediate outcome. A prospective observational study was conducted in tertiary care institute of Northern India. Children aged between 1 month and 18 years with CSE were enrolled and followed up till discharge. Primary outcome was kept as hospital survival/mortality; those who survived were further graded on the basis of disability at discharge. A total of 81 patients with CSE were assessed for primary outcome. The mortality rate was found to be 15% (12/81); 83% deaths were due to acute central nervous system (CNS) infection. Ten percent of children (8/81) had disability at discharge, five had mild, and three had moderate disability. The neurocysticercosis was the most common etiology seen in 23% (19/81) of the children followed by febrile SE in 20% (13/81) of the study participants. CSE responded to first-line antiepileptic drugs (AED) in 15% children (12/81). Refractory status was seen in 13.5% (11/81) cases. Prehospital treatment was received only in 15% patients. Young age, low Glasgow coma scale score at admission, and requirement of critical care support were the factors found to be significantly associated with mortality. CSE has a high mortality especially in young children and acute CNS infections are the most common cause of it.

The etiologies and outcome of convulsive status epilepticus in children at tertiary care hospital Kashmir India

“…In our study, the mean age of the children was 4.9 years and 55.4% were male patients. The increased prevalence of CSE in children <5 years of age has been reported in various studies conducted across India (Chin, 8 Bergamo et al, 9 and Admuthe et al, 10 in their study have also observed the mean age for the CSE 4.5 years and findings are consistent with our study.…”

“…Similar risk factors were found in other studies. 10,[15][16][17] In our study, the outcome was good among cases who had traveled <10 km and was very high among 24 children who had traveled more than 40 km. The study revealed that the lower the distance to the treating hospital, the better the outcome and vice voce.…”

Disability and Mortality in Convulsive Status Epilepticus in Children at 3 Months' Follow-Up: A Prospective Study from India

“…A previous study from this center also had higher mortality in females. 5 Two out of three deaths during follow-up were due to seizures and one due to aspiration. All of them were in a persistent vegetative state at the time of discharge.…”

“…[1][2][3][4] The mortality at discharge in resource-poor countries ranges between 10 and 30%, whereas in developed nations it is 2 to 7%. [5][6][7][8] In a review by Sculier et al, long-term mortality after status epilepticus (SE) was noticed up to 20% in children and 55% in adults; in older studies mortality was higher whereas in newer studies it was < 5%. 4 Pujar et al reported 11% case fatality rate on 8-year follow-up of childhood CSE.…”