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Pediatrics Education and Research

Volume  6, Issue 3, Sep-Dec 2018, Pages 159-164
 

Original Article

Outcome of Convulsive Status Epilepticus in Children: A Cross Sectional Study

Rajniti Prasad1, Sujoy Saha2, Ashish Verma3, Om Prakash Mishra4, Utpal Kant Singh5, Tej Bali Singh6, Ankur Singh7

1Professor & Head 2Resident 4,5Professor 7Assistant Professor, Department of Paediatrics, 3Associate Professor, Department of Radiodiagnosis 6Professor, Division of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India.

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DOI: https://dx.doi.org/10.21088/per.2321.1644.6318.5

Abstract

Background: Convulsive status epilepticus (CSE) is the most common neurological emergency in children and often associated with poor outcome. A prospective cross sectional study was done on 193 north Indian children with CSE, aged one month to 15 years presented in pediatric emergency with primary objective was to record the time taken to control seizure and secondary objective was to find out etiology, laboratory changes, neuroimaging findings. Methods: Children (1 month to 180 months) were recruited in study as per protocol. Seizure was managed as per hospital and Indian Academy of paediatrics protocol. Data was entered in predesigned proforma and analyzed for outcomes. Results: The mean age of children was 56.7±47.1 months, where as male: female ratio was 2.3:1. Seventy four (38.3%) children belonged to the age group 61-180 months, followed by 13-60 months (34.7%) and 1-12 months (26.9%). Fever; 87 (45.1%) was most common associated symptom followed by vomiting (29.5%), headache (4.7%), and diarrhoea (3.1%). Seizure was clinically controlled (Group-I) in 149 (77.2%), partially controlled (Group-II) in 25 (12.95%), and 19 (9.84%) patients had died (Group-III). The mean duration of CSE at presentation was significantly higher in Group-II and group-III. The mean time taken to control seizure in group-I was 49.7±54.1 minutes, groupII; 135.8±77.7 minutes and in group-III; 118.21±97.5 minutes respectively. The most common CT-scan finding was meningoencephalitis 43 (22.3%), followed by tubercular meningitis 34 (17.6%), bacterial meningitis 33 (17.1%), neurocysticercosis 19 (9.8%) and cerebral infarction (5.2%). CSE was controlled with lorazepam and phenytoin in most of children. Conclusion: The duration of CSE at presentation, number of seizure episodes, time taken to control status epilepticus and etiology were the important factors for outcome of status epilepticus. 


Keywords : Keywords: Convulsive Status Epilepticus (CSE); Generalized Tonic Clonic Seizure; Partial Seizure; Prolonged Febrile Seizure; Lorazepam; Phenytoin; Midazolam; Sodium Valproate.  
Corresponding Author : Rajniti Prasad, Professor & Head, Department of Paediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India.