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The etiology and prognosis of super-refractory convulsive status epilepticus in children
- Source :
- Epilepsy & Behavior. 86:66-71
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Both refractory convulsive status epilepticus (SE) and super-refractory SE are medical emergencies. However, there are limited data on super-refractory SE in children. Thus, this study focuses on characterizing the demographics, outcomes, and prognostic factors for super-refractory SE in children.This study was a retrospective analysis of super-refractory SE treated in a tertiary referral center in Taiwan. The functional outcome was evaluated by modified Rankin scale (mRS). Significant functional decline was defined as an mRS difference (before hospital admission and at discharge) of more than 2. The variates and the follow-up mRS values were then analyzed statistically.We enrolled 134 patients with 191 episodes of convulsive SE and identified 30 patients with 38 episodes of convulsive super-refractory SE. The incidence of convulsive super-refractory SE in the group with SE was 19.9%, and the age ranged from 2.5 months to 17 years. In-hospital mortality was 13.3%, which was much lower than that of adult cohorts. Newly acquired epilepsy and cognitive deficit occurred in 100% and 88.5%, respectively. Newly acquired epilepsy, as a sequel of super-refractory SE, was observed in all 18 patients (100%) who survived and had no history of epilepsy. Significant functional decline (mRS difference of more than 2) at discharge occurred in 76.7%. Poor functional outcome was associated with acute symptomatic etiology (P 0.001) and the number of anesthetic agents (P = 0.002). The functional outcome improved after 1 year of follow-up in our population.Super-refractory SE is associated with significant morbidity and mortality in children. However, the in-hospital mortality rate is much lower compared with adults. The functional outcome in children is associated with acute symptomatic etiology and the number of anesthetic agents and may improve after long-term follow-up.
- Subjects :
- Male
Drug Resistant Epilepsy
Pediatrics
medicine.medical_specialty
Adolescent
Critical Care
Status epilepticus
03 medical and health sciences
Behavioral Neuroscience
Epilepsy
Status Epilepticus
0302 clinical medicine
Refractory
Modified Rankin Scale
medicine
Humans
Anesthesia
Cognitive Dysfunction
Hospital Mortality
030212 general & internal medicine
Child
Cognitive deficit
Anesthetics
Retrospective Studies
business.industry
Incidence
Incidence (epidemiology)
Mortality rate
Length of Stay
Prognosis
medicine.disease
Hospitalization
Treatment Outcome
Neurology
Child, Preschool
Etiology
Female
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15255050
- Volume :
- 86
- Database :
- OpenAIRE
- Journal :
- Epilepsy & Behavior
- Accession number :
- edsair.doi.dedup.....f92a995138ca55bfa87496ed5d0c49e9