The prognostic factors in children with status epilepticus & status epilepticus severity score scales

Abstract

Status epilepticus according to International League Against Epilepsy (ILAE) 2015’ classification is a seizure that lasts longer than 5 minutes or has more than 1 seizure within 5 minutes, without returning to a normal level of consciousness between episodes. In this study, we aimed to determine the prognostic factors in status epilepticus and to compare our patients to score systems that are used internationally as PEDSS Pediatric Cerebral Performance Category Scale, EEG, Drug refractoriness, Semiology, and Critical Sickness and mSTESS modified Status Epilepticus Severity Score to determine the prognosis. of SE to find out the availability of these score systems. Method &Material: The medical records of patients aged 1 month to 17 years with status epilepticus who approached Çukurova University-Balcalı Training and Research Hospital from September 2018 to September 2021 followed in the intensive care unit were included in the study. Results: The mean age of the patients with SE is 5 years old (3–8). The male-to-female ratio is 34 (47%) / 38(53%). A history of epilepsy was present in 53% of the patients. The most common etiologies behind SE were meningoencephalitis (19%), febrile status ( 10%), unknown 9 (12%), and genetic causes ( 7%). The co-morbidities including developmental delay/intellectual disability, cerebral palsy, vision/ hearing impairment, hyperactivity, and autism spectrum disorder were present in 44(61%) of the patients with SE. The cut-off was > 2 for unfavorable outcomes and 4 for mortality with the scoring system of mSTESS and the cut-off for poor prognosis was ≥ 3 at the hospital before discharge and 6 for mortality. For PEDSS score ssytem. generalized type of seizures and non-convulsive SE, slowing and abnormal ground in EEG, being stuporous or comatose, abnormal MRI-CT, higher PCPCS score, PEDSS ≥ 3, and presence of comorbid condition were in unfavorable prognosis in SE in children. Conclusion: PEDSS and mSTESS are useful and practical score systems that should be used in predicting the prognosis of status epilepticus. Generalized type of seizures and non-convulsive SE, slowing and abnormal ground in EEG, being stuporous or comatose, abnormal MRI-CT, and presence of comorbid condition were in favour of poor prognosis in status epilepticus in children.