Clinical Characteristics of Status Epilepticus as the First Presentation of Fever Related Seizure in Children
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Purpose: Status epilepticus (SE) is a neurological emergency disease because it can cause severe neurological complications. In order to avoid these complications, early diagnosis and appropriate treatment is required in SE. Febrile SE is the most common form of SE in children. We investigated the clinical characteristics and prognosis of patients with febrile SE is the first seizure of life. Methods: We retrospectively reviewed the medical records of patients with SE as the first presentation of fever related seizures who visited our hospital from July 1996 to January 2013. Clinicodemographic characteristics, brain magnetic resonance imaging (MRI) and electro-encephalogram (EEG) findings, and anti-epileptic treatment were compared between two groups divided according to prognosis; fair vs. poor prognosis. Results: Seventy-eight children were included in this study. The median age of the subjects was 20.0 months (interquartile range [IQR] 12.0-42.8). Fifty-one subjects had a fair prognosis, while twenty-seven subjects had a poor prognosis. Statistically significant differences was observed in the duration of seizure (P=0.043), the number of antiepileptic drugs (P<0.001) and the presence of abnormal EEG findings (P<0.001). Conclusion: Children with febrile SE as the first seizure of life are likely to reveal a poor prognosis in those whose seizure last longer or are controlled only through high step anti-epileptic drugs. Thus, in order to ensuring a better prognosis for such patients, appropriate treatment is needed to stop the seizure.
Abstract
Purpose: Status epilepticus (SE) is a neurological emergency disease because it can cause severe neurological complications. In order to avoid these complications, early diagnosis and appropriate treatment is required in SE. Febrile SE is the most common form of SE in children. We investigated the clinical characteristics and prognosis of patients with febrile SE is the first seizure of life. Methods: We retrospectively reviewed the medical records of patients with SE as the first presentation of fever related seizures who visited our hospital from July 1996 to January 2013. Clinicodemographic characteristics, brain magnetic resonance imaging (MRI) and electro-encephalogram (EEG) findings, and anti-epileptic treatment were compared between two groups divided according to prognosis; fair vs. poor prognosis. Results: Seventy-eight children were included in this study. The median age of the subjects was 20.0 months (interquartile range [IQR] 12.0-42.8). Fifty-one subjects had a fair prognosis, while twenty-seven subjects had a poor prognosis. Statistically significant differences was observed in the duration of seizure (P=0.043), the number of antiepileptic drugs (P<0.001) and the presence of abnormal EEG findings (P<0.001). Conclusion: Children with febrile SE as the first seizure of life are likely to reveal a poor prognosis in those whose seizure last longer or are controlled only through high step anti-epileptic drugs. Thus, in order to ensuring a better prognosis for such patients, appropriate treatment is needed to stop the seizure.
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