Clinical profile and short-term outcome of convulsive status epilepticus in children aged 1 month–12 years: A prospective observational study
TL;DR
Early treatment and close monitoring of children with acute symptomatic etiology, depressed sensorium, recurrent seizures, or drug-refractory status are essential to improve short-term outcome.
Abstract
Background: Convulsive status epilepticus (CSE) is a pediatric neurological emergency requiring urgent intervention. It may result from febrile illness, central nervous system infection, metabolic disturbances, or neurological disorders and may cause morbidity, mortality, and sequelae when treatment is delayed. Aims and Objectives: The aim of the study was to describe the clinical profile and etiological spectrum of CSE in children aged 1 month–12 years and identify factors associated with short-term outcome at discharge. Materials and Methods: This prospective observational study included 100 consecutive children aged 1 month–12 years admitted with CSE to the pediatric intensive care unit or child medical ward of a tertiary care hospital. Clinical details, examination findings, investigations, neuroimaging, cerebrospinal fluid examination, and electroencephalography were recorded when indicated. Outcomes at discharge were classified as complete recovery, neurological deficit, or death. Results: Children aged 1–5 years formed the largest subgroup, with a slight male predominance. Fever was the most common clinical feature, and generalized tonic-clonic seizures were the predominant seizure type. Acute symptomatic etiology was most frequent, followed by febrile status and remote symptomatic causes. At discharge, 78% recovered completely, 16% had a neurological deficit, and 6% died. Unfavorable outcome was significantly associated with delayed treatment, seizure type, recurrent seizures after admission, acute symptomatic etiology, lower Glasgow Coma Scale score, and requirement of more antiepileptic drugs. Conclusion: Most children recovered fully; however, morbidity and mortality remained important. Early treatment and close monitoring of children with acute symptomatic etiology, depressed sensorium, recurrent seizures, or drug-refractory status are essential to improve short-term outcome.