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Crit Care Med. 1994 May;22(5):827-32.

Admissions to a pediatric intensive care unit for status epilepticus: a 10-year experience.

Author information

  • 1Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Canada.

Abstract

OBJECTIVE:

To characterize the etiology, course, and prognosis in children admitted to a pediatric intensive care unit (ICU) for status epilepticus.

DESIGN:

Retrospective, descriptive study.

SETTING:

Pediatric ICU in a university hospital.

PATIENTS:

One hundred forty-seven children admitted with status epilepticus.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Status epilepticus was defined as a prolonged (> 30 mins) or repeated tonic or tonic-clonic seizure with a persistent altered state of consciousness. Over 10 yrs, 147 children 0 to 16 yrs of age (median 1; mean 3.4 +/- 3.9 [SD]) were admitted to a pediatric ICU for, or with, 153 episodes of status epilepticus. Status epilepticus was caused most often by epilepsy (n = 52), atypical febrile convulsions (n = 21), bacterial meningitis (n = 20), encephalitis (n = 20), intoxication (n = 8), or a metabolic disorder (n = 12). Two infants, 1 and 3 months of age, and a patient with intoxication by isoniazid, responded to pyridoxine. Among 114 previously normal children, 34 patients displayed a new neurologic problem on discharge from the ICU, among whom, 68% (23/34) still had some neurologic abnormality 1 yr after the episode of status epilepticus. Nine patients died during their ICU stay, mostly from underlying disease rather than from the status epilepticus itself. A normal neurologic status before status epilepticus and age < 4 yrs seem to be markers of good prognosis, while encephalitis and meningitis appear to be markers for morbidity and mortality.

CONCLUSIONS:

Most cases of status epilepticus were caused by epilepsy, atypical febrile seizure, encephalitis, meningitis, or metabolic disease. The mortality rate during the ICU stay was 6%. The prognosis was good in most surviving cases, more so if the neurologic development of the child was normal before the status epilepticus.

PMID:
8181292
[PubMed - indexed for MEDLINE]
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