title: [Refractory status epilepticus in children: characterisation of epilepsies, continuous electroencephalographic monitoring and response to treatment].
abstract: BACKGROUND
  Patients with refractory status epilepticus (RSE) have high morbidity and mortality rates, are hospitalised for longer periods of time, suffer greater neurological damage and progress to symptomatic epilepsy. Continuous electroencephalogram (cEEG) monitoring is a valuable aid in the early detection of RSE, especially in the case of non-convulsive status epilepticus (NCSE). In this study we describe the clinical characteristics, treatment and use of cEEG in paediatric patients with RSE.
  
  
  METHODS
  A retrospective study was conducted at the Hospital Clinico de la Pontificia Universidad Catolica de Chile between November 2005 and March 2011 in patients aged between 1 month and 15 years diagnosed with RSE and cEEG. Demographic characteristics, baseline and final conditions, and therapy were recorded.
  
  
  RESULTS
  A total of 15 patients, 12 of whom were males, with a mean age of 4 years (1.5 months-13 years) were identified. Eight patients had a history of epilepsy. The most frequent aetiologies were progressive symptomatic and acute symptomatic. Convulsive epileptic status (CSE) was present in 11 patients and NCSE in the other four. During the cEEG, six of the 11 patients with CSE later progressed to NCSE. The mean amount of time with RSE was 10.2 days. Of the 15 patients, 13 responded to anticonvulsive drugs and the main secondary complications were respiratory depression and hypotension. Patients with CSE tended to evolve in a more torpid manner than patients with NCSE. On discharge from hospital, 13 patients (86.6%) presented new neurological deficit or difficult-to-manage epilepsy, one still had RSE and one died (6%).
  
  
  CONCLUSIONS
  The aggregate neurological morbidity and mortality rates of RSE were high. The use of cEEG monitoring should be considered for use in the management of such cases of status epilepticus.
authors.affiliation: División de Pediatría; Unidad de Neurología.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Cardoso
authors.forename: Keryma
authors.initials: K
authors.lastname: Acevedo
authors.forename: Marta
authors.initials: M
authors.lastname: Hernández
authors.forename: Julia
authors.initials: J
authors.lastname: Santin
authors.forename: Pedro
authors.initials: P
authors.lastname: Moya
authors.forename: Jaime
authors.initials: J
authors.lastname: Godoy
authors.forename: Andrés
authors.initials: A
authors.lastname: Castillo
authors.forename: Pilar
authors.initials: P
authors.lastname: Soto
authors.forename: Tomás
authors.initials: T
authors.lastname: Mesa
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D001925:Brain Damage, Chronic / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000209:etiology; D000013:Congenital Abnormalities; D002658:Developmental Disabilities / Q000209:etiology; D004351:Drug Resistance; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis / Q000150:complications; D012120:Respiration Disorders / Q000209:etiology; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000927:Anticonvulsants