title: Prolonged refractory status epilepticus with early and persistent restricted hippocampal signal MRI abnormality.
abstract: We report a series of four children with a prolonged refractory status epilepticus with an early persistent and restricted hippocampal signal MRI abnormality but otherwise no proven etiology. The mean duration of status epilepticus was 53 days (range, 20-91 days) with a mean length of stay in Pediatric Intensive Care Unit (PICU) of 2 months (range, 26-115 days). Neurological outcome showed epilepsy disease in all, and mild to severe disability. In long-term follow-up, the initial MRI signal abnormality developed into a cortical atrophy in all cases. The establishment of the diagnosis, etiology, and options for treatment are discussed.
authors.affiliation: Pediatric Intensive Care Unit, CHU Bicêtre, 78, rue du Gal Leclerc, 94275 Le Kremlin Bicêtre, France. laurent.chevret@bct.aphp.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Chevret
authors.forename: Beatrice
authors.initials: B
authors.lastname: Husson
authors.forename: Seraphin
authors.initials: S
authors.lastname: Nguefack
authors.forename: Astrid
authors.initials: A
authors.lastname: Nehlig
authors.forename: Viviane
authors.initials: V
authors.lastname: Bouilleret
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001284:Atrophy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D001327:Autoimmune Diseases / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D001925:Brain Damage, Chronic / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004195:Disease Models, Animal; D018450:Disease Progression; D004660:Encephalitis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D005334:Fever / Q000150:complications; D006261:Headache / Q000150:complications; D006624:Hippocampus / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D020363:Limbic Encephalitis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D013226:Status Epilepticus / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D013997:Time Factors
chemical_list: D000927:Anticonvulsants; D000998:Antiviral Agents