Childhood convulsive status epilepticus: epidemiology, management and outcome.
Convulsive status epilepticus (CSE) in childhood is a medical emergency and its aetiology and outcome mean that it should be studied separately from adult CSE. The incidence in developed countries is between 17 and 23/100,000 with a higher incidence in younger children. Febrile CSE is the commonest single group with a good prognosis in sharp distinction to CSE related to central nervous system infections which have a high mortality. The aim of treatment is to intervene at 5 min and studies indicate that intravenous (i.v.) lorazepam may be a better first-line treatment than rectal diazepam and i.v. phenytoin a better second-line treatment than rectal paraldehyde. An epidemiological study strongly supports the development of prehospital treatment with buccal midazolam becoming a widely used but unlicensed option in the community. More than two doses of benzodiazepines increase the rate of respiratory depression without obvious benefit. The 1 year recurrence rate is 17% and the hospital mortality is about 3%.
Neville
B G R
BG
Neurosciences Unit, University College, Institute of Child Health, and Great Ormond Street Hospital for Children, NHS Trust, London, UK. b.neville@ich.ucl.ac.uk
Chin
R F M
RF
Scott
R C
RC
D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome