The Clinical Characteristics of Status Epilepticus in Children

Kang, Yoon Ki; Kim, Sun Jun

Abstract

PURPOSE: Status epilepticus (SE) is one of the most common neurologic emergencies in children requiring immediate aggressive intervention. Despite advances in treatment of this condition, SE is still associated with a significant morbidity and mortality. To evaluate etiology and neurologic outcome of SE is very important for improving the methods of evaluation and management of SE as well as decreasing morbidity and mortality.
METHODS
We retrospectively reviewed the records of 98 children aged 1 month to 15 years who were admitted to our department of pediatrics from January, 1992 to December, 1998. We analyzed age distribution, etiology, seizure type, abnormalities of EEG and brain MRI, and neurologic outcome. We try to find any coherence between neurologic sequelae and clinical factors.
RESULTS
The incidence was high in toddler age, especially younger than 3 years old (67.4%). Generalized convulsive SE was the most common type (67.3%), and 54.1% of children with SE which was the first seizure episode. Major etiology of SE in young children younger than 3 years old were febrile convulsion (54.5%) and acute symptomatic causes (22.7%). Neurologic sequelae were left in 21.4% and the mortality rate was 7.1%. The neurologic complications were highly associated with the underlying causes and the seizure durations, especially over 2 hour seizures left in 75% complications. The mortality and neurologic sequelae were higher in acute symptomatic SE than other causes. Febrile SE had usually benign course, but in four in our cases showed neurologic sequale it shows 4 neurologic sequelae cases.
CONCLUSION
SE is a life-threatening neurologic condition and especially occurs in young children. The early detection of seizure etiology and aggressive management are the essential factors to decrease the mortality and morbidity rates.