Admissions to a pediatric intensive care unit for status epilepticus: a 10-year experience.
OBJECTIVE
To characterize the etiology, course, and prognosis in children admitted to a pediatric intensive care unit (ICU) for status epilepticus.


METHODS
Retrospective, descriptive study.


METHODS
Pediatric ICU in a university hospital.


METHODS
One hundred forty-seven children admitted with status epilepticus.


METHODS
None.


RESULTS
Status epilepticus was defined as a prolonged (> 30 mins) or repeated tonic or tonic-clonic seizure with a persistent altered state of consciousness. Over 10 yrs, 147 children 0 to 16 yrs of age (median 1; mean 3.4 +/- 3.9 [SD]) were admitted to a pediatric ICU for, or with, 153 episodes of status epilepticus. Status epilepticus was caused most often by epilepsy (n = 52), atypical febrile convulsions (n = 21), bacterial meningitis (n = 20), encephalitis (n = 20), intoxication (n = 8), or a metabolic disorder (n = 12). Two infants, 1 and 3 months of age, and a patient with intoxication by isoniazid, responded to pyridoxine. Among 114 previously normal children, 34 patients displayed a new neurologic problem on discharge from the ICU, among whom, 68% (23/34) still had some neurologic abnormality 1 yr after the episode of status epilepticus. Nine patients died during their ICU stay, mostly from underlying disease rather than from the status epilepticus itself. A normal neurologic status before status epilepticus and age < 4 yrs seem to be markers of good prognosis, while encephalitis and meningitis appear to be markers for morbidity and mortality.


CONCLUSIONS
Most cases of status epilepticus were caused by epilepsy, atypical febrile seizure, encephalitis, meningitis, or metabolic disease. The mortality rate during the ICU stay was 6%. The prognosis was good in most surviving cases, more so if the neurologic development of the child was normal before the status epilepticus.
Lacroix
J
J
Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Canada.
Deal
C
C
Gauthier
M
M
Rousseau
E
E
Farrell
C A
CA
D000293:Adolescent; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D011379:Prognosis; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013226:Status Epilepticus / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015996:Survival Rate