Infantile status epilepticus in Tunisia. Clinical, etiological and prognostic aspects

Tabarki, Brahim; Yacoub, M.H.; Selmi, H.; Oubich, F.; Barsaoui, Sihem; Essoussi, A S

doi:10.1053/seiz.2000.0495

Cited by 26 publications

(24 citation statements)

References 15 publications

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“…Long‐term cognitive sequelae occur in 28%‐34% of children 28, 33, 36, 37. In one adult study on long‐term cognitive sequelae after SE, no cognitive decline was found after 3 years of follow‐up, but this series included only 15 patients 10.…”

Section: Long‐term Outcomes Of Sementioning

confidence: 95%

“…Age is one of the main outcome predictors after SE,53 with the youngest (<1 year)13, 28, 36, 38 and oldest11, 12, 20 patients having the poorest long‐term outcomes (>65 years11 or odds/risk ratio = 1.04‐1.05/year12, 20). The higher mortality reported in younger children may also reflect the higher proportion of acute symptomatic cases in this age group 63, 64, 65.…”

Section: Differences Between Adult and Pediatric Populationmentioning

confidence: 99%

“…In children, many studies have pointed out remote29, 35, 36 and acute6, 17, 24, 26, 71 symptomatic causes, progressive encephalopathies,17, 26, 35, 36 or more extensively “nonfebrile‐nonidiopathic SE”28 as predictors of poor outcome. In contrast, the risks of mortality53 and neurological deficits are low with febrile SE and cryptogenic/idiopathic SE 26, 27, 28, 72.…”

Section: Factors Affecting Outcomementioning

confidence: 99%

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Long‐term outcomes of status epilepticus: A critical assessment

et al. 2018

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SummaryWe reviewed 37 studies reporting long‐term outcomes after a status epilepticus (SE) episode in pediatric and adult populations. Study design, length of follow‐up, outcome measures, domains investigated (mortality, SE recurrence, subsequent epilepsy, cognitive outcome, functional outcome, or quality of life), and predictors of long‐term outcomes are summarized. Despite heterogeneity in the design of prior studies, overall risk of poor long‐term outcome after SE is high in both children and adults. Etiology is the main determinant of outcome, and the effect of age or SE duration is often difficult to distinguish from the underlying cause. The effect of the treatment on long‐term outcome after SE is still unknown.

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Section: Long‐term Outcomes Of Sementioning

confidence: 95%

Section: Differences Between Adult and Pediatric Populationmentioning

confidence: 99%

Section: Factors Affecting Outcomementioning

confidence: 99%

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Long‐term outcomes of status epilepticus: A critical assessment

et al. 2018

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“…The variability in range may be related to age, with a higher incidence of CNS infections occurring in the younger children, or to selection criteria. 29,30,33,39,41 A class III study of 49 children with convulsive SE identified 24 children with SE and fever and in this group bacterial meningitis was detected in 4 of 9 children who had a LP done (8% of entire group and 17% of febrile group). 44 None of the 25 children without febrile SE were diagnosed with meningitis.…”

Section: Lp (Evidence)mentioning

confidence: 99%

“…Ingestion of a toxin or drug abuse are possible etiologies of SE that require very prompt diagnosis and treatment. 4,26,27,[29][30][31][32]36,37,41,43 The specific toxins were theophylline, lindane, carbamazepine, or chemotherapy. This represents a minimum rate as we used as the denominator all patients in the studies.…”

Section: Lp (Evidence)mentioning

confidence: 99%

Practice Parameter: Diagnostic assessment of the child with status epilepticus (an evidence-based review)

et al. 2006

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Abstract-Objective:To review evidence on the assessment of the child with status epilepticus (SE). Methods: Relevant literature were reviewed, abstracted, and classified. When data were missing, a minimum diagnostic yield was calculated. Recommendations were based on a four-tiered scheme of evidence classification. Results: Laboratory studies (Na ϩϩ or other electrolytes, Ca ϩϩ , glucose) were abnormal in approximately 6% and are generally ordered as routine practice. When blood or spinal fluid cultures were done on these children, blood cultures were abnormal in at least 2.5% and a CNS infection was found in at least 12.8%. When antiepileptic drug (AED) levels were ordered in known epileptic children already taking AEDs, the levels were low in 32%. A total of 3.6% of children had evidence of ingestion. When studies for inborn errors of metabolism were done, an abnormality was found in 4.2%. Epileptiform abnormalities occurred in 43% of EEGs of children with SE and helped determine the nature and location of precipitating electroconvulsive events (8% generalized, 16% focal, and 19% both). Abnormalities on neuroimaging studies that may explain the etiology of SE were found in at least 8% of children. Recommendations: Although common clinical practice is that blood cultures and lumbar puncture are obtained if there is a clinical suspicion of a systemic or CNS infection, there are insufficient data to support or refute recommendations as to whether blood cultures or lumbar puncture should be done on a routine basis in children in whom there is no clinical suspicion of a systemic or CNS infection (Level U). AED levels should be considered when a child with treated epilepsy develops SE (Level B). Toxicology studies and metabolic studies for inborn errors of metabolism may be considered in children with SE when there are clinical indicators for concern or when the initial evaluation reveals no etiology (Level C). An EEG may be considered in a child with SE as it may be helpful in determining whether there are focal or generalized epileptiform abnormalities that may guide further testing for the etiology of SE, when there is a suspicion of pseudostatus epilepticus (nonepileptic SE), or nonconvulsive SE, and may guide treatment (Level C). Neuroimaging may be considered after the child with SE has been stabilized if there are clinical indications or if the etiology is unknown (Level C). There is insufficient evidence to support or refute routine neuroimaging in a child presenting with SE (Level U).

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Frequency and Prognosis of Convulsive Status Epilepticus of Different Causes

Neligan

Shorvon²

2010

Arch Neurol

217

144

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e conducted a systematic review of all studies of status epilepticus (SE) with more than 30 patients published between January 1, 1990, and December 31, 2008, to determine the frequencies of the common underlying causes and the extent to which the underlying causes affect the prognosis of an episode of SE. The frequencies of underlying causes vary among studies and show marked geographic differences, but in most studies, the most common underlying causes were cerebrovascular disease and low antiepileptic drug levels. A relatively good prognosis of SE is found when the underlying cause is associated with low antiepileptic drug levels or alcohol abuse, and a relatively poor outcome occurs when the underlying cause is cerebrovascular disease, particularly in the case of SE due to acute cerebral anoxia, but in most conditions, the reported prognosis is variable. Also, when SE occurs in the context of an acute cerebral insult, such as cerebral infection or cerebrovascular disease, the prognosis of the acute cerebral event is worsened.

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Infantile status epilepticus in Tunisia. Clinical, etiological and prognostic aspects

Cited by 26 publications

References 15 publications

Long‐term outcomes of status epilepticus: A critical assessment

Long‐term outcomes of status epilepticus: A critical assessment

Practice Parameter: Diagnostic assessment of the child with status epilepticus (an evidence-based review)

Frequency and Prognosis of Convulsive Status Epilepticus of Different Causes

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