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186987

Clinical characteristics and outcome in children with convulsive status epilepticus

Article

Last updated: 22 Jan 2023

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Abstract

ABSTRACT Background: Status epilepticus (SE) is a serious neurological emergency that is associated with increased morbidity and mortality. There is emerging interest in understanding the clinical characteristics and identification of the prognosis of children with SE. Objective: To identify the clinical profile and prognosis of children presenting by status epilepticus. Methodology: This is a descriptive analytical study carried out on 31 children who presented by convulsive SE and were admitted to the pediatric intensive care unit. Clinical data, Complete blood count, C-reactive protein, erythrocyte sedimentation rate, serum glucose & electrolytes and cerebrospinal fluid analysis were estimated. Magnetic resonance imaging was done to all included children. Results: Most of the children who presented with SE were younger than 5 years of age (45.2% were <2 years and 32.2% were 2-5 years). 74.2% were males and 83.9% had generalized seizures. 29% had SE as a first presentation. 77.4% were known cases of epilepsy. Non epileptic causes included encephalitis (12.9%), febrile convulsion (a typical) (6.5%) and acute hypoxia (shocking) (3.2%). The main precipitating factors for SE were missing doses in 29%, acute febrile Illness in 12.9%, acute hypoxia in 6.5%, while precipitating factors could not be identified in 41.9% of children. Most children had normal MRI (64.5%). The commonest abnormalities were diffuse hypoxia and encephalitis (12.9% for each). 70.9% of children survived without neurological sequeals, 19.4% developed neurological sequels while 9.7% died. Non-epileptic etiology, febrile illness, hypoxia, elevated acute phase reactant (erythrocytes sedimentation rate and C-reactive protein) was significantly associated with poor outcome. Conclusion: Despite that epilepsy is the main cause of SE, non-epileptic causes are more serious and are associated with a worser outcome. Male gender, poor compliance to antiepileptic medications and febrile illness are linked to the development of SE in children. SE induced by hypoxia and encephalitis had the highest morbidity and mortality.

DOI

10.21608/jram.2021.63973.1111

Keywords

Status epileptics, Seizures, Outcome, children

Authors

First Name

Marwa

Last Name

Elhady

MiddleName

-

Affiliation

Pediatric Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt.

Email

marwaelhady93@yahoo.com

City

-

Orcid

0000-0002-7785-3736

First Name

Areej

Last Name

Mohammad

MiddleName

M

Affiliation

Pediatric Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt.

Email

dr.areejsaleh@gmail.com

City

-

Orcid

-

First Name

Eman

Last Name

Khaled

MiddleName

M

Affiliation

Pediatric Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt.

Email

dremankhaled@yahoo.com

City

-

Orcid

-

First Name

Asmaa

Last Name

Hasan

MiddleName

S

Affiliation

Clinical Pathology Department, Faculty of Medicine for Girls Cairo, Al-Azhar, University, Egypt.

Email

asmsobhy@gmail.com

City

cairo

Orcid

-

Volume

2

Article Issue

2

Related Issue

26940

Issue Date

2021-07-01

Receive Date

2021-02-19

Publish Date

2021-07-01

Page Start

194

Page End

203

Print ISSN

2636-252X

Online ISSN

2636-2538

Link

https://jram.journals.ekb.eg/article_186987.html

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https://jram.journals.ekb.eg/service?article_code=186987

Order

8

Type

Original Article

Type Code

676

Publication Type

Journal

Publication Title

Journal of Recent Advances in Medicine

Publication Link

https://jram.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023