A Clinical Study of Acute Symptomatic Seizures in Children

Lee, Kyeong Eun; Kim, Won Seop

Abstract

PURPOSE: To determine the incidence, etiology, sex, age, seizure type and prognosis of acute symptomatic seizures in children and evaluate the hypothesis that acute symptomatic status epilepticus(SE) is associated with an increased risk of subsequent unprovoked seizure compared with the risk of acute syrnptomatic seizure without SE.
METHODS
Five hundred and sixty-eight convulsive children visited the Pediatric Department of Chungbuk National University Hospital from February 1991 to February 1999. Of these, 109 patients were determined as acute symptomatic seizure, and their medical record were reviewed.
RESULTS
One hundred and nine children(59#boys, 50#girls) had acute symptomatic seizures, the ratio of male to female and the ages at the onset of first seizure were 1.18: 1 and 1.58+/-2.53 years, respectively. Causes of acute symptomatic seizure in order of frequency were acute gastroenteritis(33.0%), encephalopathy(31.2%), metabolic/toxic disturbance(19.3%), CNS infection (11.0%), brain trauma(2.8%), cerebrovascular disease(1.8%) and CNS tumor(0.9%). At six months of follow-up, the incidence of a first unprovoked seizure was 28.4% for children with acute symptomatic seizure, 67.6% for those with encephalopathic cause, 44% for those with structural cause, and O% for those with metabolic cause. At six months of follow-up, the risk of a first unprovoked seizure was significantly greater for those with acute symptornatic seizure with SE(100%) than without SE(22%).
CONCLUSION
The leading causes of acute syrnptomatic seizures were acute gastroenteritis. Age-specific incidence was highest in the group aged 0-12 rnonths. The incidence of subsequent un-provoked seizure was highest in the group of encephalopathy. The risk for subsequent un-provoked seizure was greater for those with SE than for those without SE and for those with abnormal EEG and abnormal findings of neuroimage.