Status Epilepticus in Pediatric patients Severity Score (STEPSS): A clinical score to predict the outcome of status epilepticus in children- a prospective cohort study

Abstract

In adults, the Status Epilepticus Severity Score (STESS), a clinical score, has been shown to be a good predictor of outcome and treatment response. We devised a pediatric modification of this score: the Status Epilepticus in Pediatric patients Severity Score (STEPSS) and evaluated it in children with status epilepticus. Methods: In this prospective study, children aged 1 month to 18 years presenting with seizure duration ≥ 5 min or actively convulsing to the emergency room were enrolled. STEPSS score was calculated at the time of admission. Outcomes included death, the Pediatric Overall Performance Category (POPC) at discharge and treatment response. The diagnostic utility of the STEPSS score to predict unfavourable outcome was evaluated. Results: One-hundred and forty children (mean age 5.8 years) were enrolled. Seven children died and overall 15 children had an unfavourable outcome. The predictive accuracy of STEPSS at a cut-off of > 3: for unfavourable outcome (POPC score ≥ 3) -sensitivity (0.

Development of a novel outcome prediction score (PEDSS) for pediatric convulsive status epilepticus: A longitudinal observational study

“…In the recent past, a modification of STESS has been validated in a pure pediatric population. 17 T A B L E 1 Clinical and demographic profile of the study population In the present study, PCPCS score prior to onset of this episode of SE, seizure semiology, presence of BDZR, shock, MODS and endotracheal intubation, and conversion to RSE and SRSE were significantly different between good and poor outcome cases. At 3 months from discharge, except for PCPCS score prior to onset of this episode of SE and conversion to SRSE, the same features, and in addition proportion of cases with abnormal EEG background and NCSE, differed significantly between good and poor outcome cases.…”

“…Except for the EMSE, all previous scores have used only NCSE as an EEG component. Background abnormalities and specific discharge patterns have been used in the EMSE score [11][12][13][14][15][16][17] Studies in CSE and post-cardiac arrest pediatric populations have indicated the presence of isoelectric low-voltage unreactive background activity to be a marker of poor outcome. 29,30 Similarly in an adult study of patients with altered sensorium, abnormal background was seen to be predictive of poor outcome.…”

“…16 Recently, a pediatric modification of STESS has been validated that has been found useful for predicting treatment response, mortality, and acute outcome. 17 It has been seen that patients with CSE continue to recover further after discharge, with documented improvement at 90 days postdischarge. 18 Thus functional state of patients at discharge may not be reflective of actual recovery from CSE.…”

Etiology, Risk Factors, Mortality and Morbidity of Status Epilepticus in Children: A Retrospective Cross-Sectional Study in Tehran, Iran

“…Early diagnosis and initiation of treatment are crucial since SE can result in significant brain damage [3]. Generally, the incidence of SE is estimated at about 18-28 cases per 100,000 persons yearly [4,5]. The prevalence of SE in the United States is 50,000-150,000 per year [6].…”

“…This imposes considerable challenges to the health system. Negative effects of SE depend on the duration and type of seizures [5]. Generally, SE divides into two groups: convulsive and non-convulsive.…”