Soydan Ekin, Guzin Yigithan, Topal Sevgi, Atakul Gulhan, Colak Mustafa, Seven Pinar, Sandal Ozlem Sarac, Ceylan Gokhan, Unalp Aycan, Agin Hasan
From the Pediatric Intensive Care Unit.
Department of Pediatric Neurology, Dr. Behcet Uz Children's Hospital, University of Health Sciences, Izmir, Turkey.
Pediatr Emerg Care. 2023 Mar 1;39(3):142-147. doi: 10.1097/PEC.0000000000002915. Epub 2023 Feb 16.
Status epilepticus (SE) is associated with significant morbidity and mortality in children. SE in the pediatric intensive care unit (PICU) are not well characterized. The aim of this study is to retrospectively investigate the clinical features and treatment of seizures in children admitted to the PICU of our hospital.
We retrospectively examined the clinical characteristics of patients aged between 1 month and 18 years who were admitted to our hospital with SE or who were diagnosed with SE after hospitalization and were followed up with continuous electroencephalographic monitoring between January 2015 and December 2019.
A total of 88 patients with SE, 50 (56.8%) boys and 38 (43.2%) girls, were included. The median age was 24 months (interquartile range, 12-80 months). When we evaluate the continuous electroencephalographic monitoring data, 27 (30.7%) were lateralized, 20 (22.7%) were multifocal, 30 (34.1%) were generalized, and 11 (12.5%) were bilateral independent epileptic activity. Seventy nine patients (89.8%) were evaluated as convulsive status epilepticus (CSE) and 9 (10.2%) as nonconvulsive status epilepticus (NCSE). Pediatric Risk of Mortality (PRISM III) score and mortality of patients with NCSE were higher ( P = 0.004 and P = 0.046, respectively). Thirteen eight patients (43.1%) were diagnosed as SE, 38 patients (43.1%) as refractory SE, and 12 patients (13.6%) as super-refractory SE. The overall mortality rate was 10.2%.
Status epilepticus is a neurological emergency that causes mortality and morbidity. Electroencephalographic monitoring is important for the recognition of seizures and rapid intervention. No superiority of second-line treatments or combined treatments was demonstrated in patients with SE.
癫痫持续状态（SE）与儿童的显著发病率和死亡率相关。儿科重症监护病房（PICU）中的SE特征尚不明确。本研究的目的是回顾性调查我院PICU收治的儿童癫痫发作的临床特征及治疗情况。
我们回顾性分析了2015年1月至2019年12月期间入院时患有SE或住院后被诊断为SE并接受持续脑电图监测的1个月至18岁患者的临床特征。
共纳入88例SE患者，其中男孩50例（56.8%），女孩38例（43.2%）。中位年龄为24个月（四分位间距，12 - 80个月）。在评估连续脑电图监测数据时，27例（30.7%）为局灶性，20例（22.7%）为多灶性，30例（34.1%）为全面性，11例（12.5%）为双侧独立癫痫样放电。79例患者（89.8%）被评估为惊厥性癫痫持续状态（CSE），9例（10.2%）为非惊厥性癫痫持续状态（NCSE）。NCSE患者的儿科死亡风险（PRISM III）评分及死亡率更高（分别为P = 0.004和P = 0.046）。43例患者（43.1%）被诊断为SE，38例患者（43.1%）为难治性SE，12例患者（13.6%）为超难治性SE。总死亡率为10.2%。
癫痫持续状态是一种导致死亡率和发病率的神经急症。脑电图监测对于癫痫发作的识别和快速干预很重要。在SE患者中未显示二线治疗或联合治疗有优越性。
