Recurrent status epilepticus in children

Shinnar, Shlomo; Maytal, Joseph; Krasnoff, Lawrence; Moshé, Solomon L.

doi:10.1002/ana.410310606

Cited by 99 publications

(61 citation statements)

References 18 publications

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“…In patients with SE, the occurrence of recurrent SE ranges from 10% to 56% in children28, 29, 34, 35 and from 13% to 37% in mixed population of adults and children 8, 9. Predictors of recurrent SE include age < 4 years,8 female gender, nonresponse to first ASM for SE,9 and remote symptomatic and progressive etiologies 9, 35…”

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

“…Predictors of recurrent SE include age < 4 years,8 female gender, nonresponse to first ASM for SE,9 and remote symptomatic and progressive etiologies 9, 35…”

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

“…Long‐term mortality data after an episode of SE, including in‐hospital deaths, is 0%‐22% in children5, 6, 17, 26, 27, 28, 29, 33, 34, 35, 37, 38, 45, 53 and 0%‐57% in adults 10, 11, 12, 17, 19, 20, 43, 54…”

Section: Long‐term Outcomes Of Sementioning

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: 99%

“…Predictors of recurrent SE include age < 4 years,8 female gender, nonresponse to first ASM for SE,9 and remote symptomatic and progressive etiologies 9, 35…”

Section: Long‐term Outcomes Of Sementioning

confidence: 99%

Section: Long‐term Outcomes Of Sementioning

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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“…Infection with fever is by far the most common etiology in children, and alcohol use is rare, but the diversity of etiologies in childhood is similar to adults. The risk of recurrence is greatest (40% to 6Wo) in children with acute and chronic CNS insults and least (4%) in those with idiopathic causes or febrile status (15). The etiology is highly age dependent in the pediatric age group.…”

Section: Risk Factors For Occurrence Of Gcsementioning

confidence: 99%

Status Epilepticus: Risk Factors and Complications

2000

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Summary: Status epilepticus is common and associated with significant mortality and complications. It affects approximately 50 patients per 100,000 population annually and recurs in >13%. History of epilepsy is the strongest single risk factor for generalized convulsive status epilepticus. More than 15% of patients with epilepsy have at least one episode of status epilepticus and low antiepileptic drug levels are a potentially modifiable risk factor. Other risks include young age, genetic predisposition, and acquired brain insults. Fever is a very common risk in children, as is stroke in adults. Mortality rates are 15% to 20% in adults and 3% to 15% in children. Acute complications result from hyperthermia, pulmonary edema, cardiac arrhythmias, and cardiovascular collapse. Long‐term complications include epilepsy (20% to 40%), encephalopathy (6% to 15%), and focal neurologic deficits (9% to 11%). Neuronal injury leading to temporal lobe epilepsy is probably mediated by excess excitation via activation of the N‐methyl‐D‐aspartate (NMDA) subtype of glutamate receptors and consequent elevated intracellular calcium that causes acute necrosis and delayed apoptotic cell death. Some forms of nonconvulsive status epilepticus may also lead to neuronal injury by this mechanism, but others may not. Based on clinical and experimental observations, complex partial status epilepticus is more likely to result in neuronal injury similar to generalized convulsive status epilepticus. Absence status epilepticus is much less likely to result in neuronal injury, and complications because it may be mediated primarily through excess inhibition. Future research strategies to prevent complications of status epilepticus include the study of new drugs (including NMDA antagonists, new drug delivery systems, and drug combinations) to stop seizure activity and prevent acute and delayed neuronal injury that leads to the development of epilepsy.

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Age-dependent consequences of seizures: Relationship to seizure frequency, brain damage, and circuitry reorganization

Lado

Sankar

Lowenstein

et al. 2000

Ment. Retard. Dev. Disabil. Res. Rev.

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Seizures in the developing brain pose a challenge to the clinician. In addition to the acute effects of the seizure, there are questions regarding the impact of severe or recurrent seizures on the developing brain. Whether provoked seizures cause brain damage, synaptic reorganization, or epilepsy is of paramount importance to patients and physicians. Such questions are especially relevant in the decision to treat or not treat febrile seizures, a common occurrence in childhood. These clinical questions have been addressed using clinical and animal research. The largest prospective studies do not find a causal connection between febrile seizures and later temporal lobe epilepsy. The immature brain seems relatively resistant to the seizure‐induced neuronal loss and new synapse formation seen in the mature brain. Laboratory investigations using a developmental rat model corresponding to human febrile seizures find that even though structural changes do not result from hyperthermic seizures, synaptic function may be chronically altered. The increased understanding of the cellular and synaptic mechanisms of seizure‐induced damage may benefit patients and clinicians in the form of improved therapies to attenuate damage and changes induced by seizures and to prevent the development of epilepsy. MRDD Research Reviews 2000;6:242–252. © 2000 Wiley‐Liss, Inc.

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Recurrent status epilepticus in children

Cited by 99 publications

References 18 publications

Long‐term outcomes of status epilepticus: A critical assessment

Long‐term outcomes of status epilepticus: A critical assessment

Status Epilepticus: Risk Factors and Complications

Age-dependent consequences of seizures: Relationship to seizure frequency, brain damage, and circuitry reorganization

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