Rajper Sanam B, Moazzam Mujtaba, Zeeshan Arsheen, Abbas Qalab
Department of Pediatrics and Child Health, Aga Khan University Karachi, Karachi, Pakistan.
Medical College, Aga Khan University Karachi, Karachi, Pakistan.
J Pediatr Neurosci. 2020 Oct-Dec;15(4):375-378. doi: 10.4103/jpn.JPN_140_19. Epub 2021 Jan 19.
Critically ill individuals have an increased risk of acute symptomatic seizures secondary to systemic illnesses; unrecognized or untreated seizures can quickly convert into status epilepticus, which is associated with high morbidity and mortality.
The aim of this study was to determine frequency, etiology, and outcome of seizures in critical ill children admitted in intensive care unit of a tertiary care hospital.
Retrospective review of medical records of all children admitted in pediatric intensive care unit (PICU) of the Aga Khan University from January 2016 to December 2018 and who had a new-onset seizure irrespective of underlying diagnosis was carried out after ethical review committee approval. Data were collected on a structured proforma; it included demographic information as well as relevant clinical and outcome information. The data were analyzed on Statistical Package for the Social Sciences (SPSS) software program, version 19.0. The descriptive statistics frequency and percentage was computed for qualitative variable. Mean and standard deviation were computed for quantitative variable, and univariate analysis was performed.
During the study period, a total 2053 patients were admitted in the PICU. One hundred six (5%) had seizure. Sixty-three (59.5%) were males. Meningitis 21 (20%), sepsis 21 (20%), complicated pneumonia 18 (17%) were the major primary diagnosis in these children. Mean age of the study population was 75 months (standard deviation [SD] ± 54.4) and 72 (68%) were <5 years of age, whereas 63 (59.5%) were males. The seizures lasted >10min in 10 (10%) and were associated with high had neurological deficit ( = 0.001). We did not observe any correlation with electrolyte imbalance, renal failure, need of ventilator support with duration of seizure, and type of seizure ( > 0.005).
Infection was the most common etiology associated with a new-onset seizure in children admitted in our PICU. Seizures lasting for >10min were observed with high neurological deficit. We did not find any association of mortality with seizure duration.
危重症患者因全身性疾病继发急性症状性癫痫发作的风险增加；未被识别或未治疗的癫痫发作可迅速转变为癫痫持续状态，这与高发病率和死亡率相关。
本研究旨在确定在一家三级医院重症监护病房收治的危重症儿童癫痫发作的频率、病因及结局。
在伦理审查委员会批准后，对2016年1月至2018年12月在阿迦汗大学儿科重症监护病房（PICU）收治的所有新发癫痫发作且不论基础诊断如何的儿童的病历进行回顾性分析。通过结构化表格收集数据；包括人口统计学信息以及相关临床和结局信息。数据在社会科学统计软件包（SPSS）19.0版软件程序上进行分析。计算定性变量的描述性统计频率和百分比。计算定量变量的均值和标准差，并进行单因素分析。
在研究期间，PICU共收治2053例患者。106例（5%）有癫痫发作。63例（59.5%）为男性。脑膜炎21例（20%）、脓毒症21例（20%）、复杂性肺炎18例（17%）是这些儿童的主要初始诊断。研究人群的平均年龄为75个月（标准差[SD]±54.4），72例（68%）年龄<5岁，63例（59.5%）为男性。10例（10%）癫痫发作持续>10分钟，且与高神经功能缺损相关（P = 0.001）。我们未观察到癫痫发作持续时间、癫痫发作类型与电解质失衡、肾衰竭、呼吸机支持需求之间存在任何相关性（P>0.005）。
感染是我院PICU收治的儿童新发癫痫发作最常见的病因。观察到癫痫发作持续>10分钟与高神经功能缺损相关。我们未发现死亡率与癫痫发作持续时间之间存在任何关联。
