[Markers of poor prognosis in convulsive status epilepticus].
OBJECTIVE
To characterize the variables that might be associated with mortality and the development of neurological deficits in children with convulsive status epilepticus.


METHODS
Children older than 1 month and younger than 15 years who were admitted to the pediatric intensive care unit of a university hospital between 2001 and 2004 were reviewed. Epidemiologic and clinical factors that might be related to neurological outcome at discharge from the unit were analyzed.


RESULTS
Forty-one patients (median age 24 months) were included. A total of 48.3% developed refractory convulsive status epilepticus. Six patients died (mortality 14.6%) during their intensive care unit stay and neurologic worsening was observed in 8.6% of survivors (adverse outcome in 22%). Symptomatic epilepsy was present in all patients who died and in 88.9% of those who recovered with severe neurologic sequelae. Uni- and multivariate analysis showed that adverse outcome was related to symptomatic origin and refractory convulsive status epilepticus (p < 0.05).


CONCLUSIONS
Mortality and morbidity is high in childhood convulsive status epilepticus. Refractory convulsive status and symptomatic origin were markers of poor outcome. Children who did not have symptomatic epilepsy had a favorable outcome.
Reig Sáenz
R
R
Sección de Cuidados Intensivos Pediátricos, Hospital General Universitario de Alicante, Spain. reig_rob@gva.es
Sánchez Miralles
A
A
Herrera Murillo
M
M
González Lorenzo
M
M
Martínez Salcedo
E
E
Almanza López
S
S
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000150:complications* / Q000401:mortality*