Characteristics of Children Whose First Seizure Attack Presented as Status Epilepticus

Park, Seok Woo; Chang, Ji Yeon; Kwon, Young Se; Hong, Young Jin; Son, Byong Kwan

Abstract

PURPOSE: Status epilepticus(SE) is a pediatric and neurologic emergency associated with significant morbidity and mortality. Prompt recognition and management are needed for successful outcomes. We evaluated, clinical manifestations, treatment and prognosis of the patients whose first seizure attacks were presented as SE.
METHODS
According to the department of pediatrics and the emergency room in Inha University Medical Center, there were a total of 25 children between 1 month and 5 years old who were diagnosed as status epilepticus from July 1996 to June 2002. Also, their medical records were reviewed and analyzed interms of age distribution, accompaning diseases, the types and duration of convulsion, medications, EEG and MRI findings and prognosis.
RESULTS
Twenty-five cases were studied. The mean age at the time of the diagnosis was 20+/-1.6 months and 80% of the patients were less than 3 years old. The most common type of the status epilepticus was generalized tonic clonic seizure comprising 15 cases(60%). 64% of the patients were symptomatic:fever(40%), CNS infection(20%), ischemic injury(4%) while 36% were idiopathic. Seizure attacks were terminated within an hour in seventeen patients(68%) and they controlled by one antiepileptic drug in thirteen patients(52%). Of the 20 EEGs, abnormal findings were shown in 13 cases(65%); namely, electrical seizure(30%), abnormal background(30%), and focal epileptiform discharge(5%). Of the 19 brain MRIs, abnormal findings were shown in 9 cases(47%).
CONCLUSION
The children whose first seizure attack were presented as SE were less than 3 years old. The prognosis is good in that most of the seizure attacks were terminated within an hour and controlled by one epileptic drug. However those seizure attacks with longer duration, multiple antiepileptic druge and underlying causeare had poor prognosis.