title: Electrographic seizures after convulsive status epilepticus in children and young adults: a retrospective multicenter study.
abstract: OBJECTIVE
  To describe the prevalence, characteristics, and predictors of electrographic seizures after convulsive status epilepticus (CSE).
  
  
  METHODS
  This was a multicenter retrospective study in which we describe clinical and electroencephalographic (EEG) features of children (1 month to 21 years) with CSE who underwent continuous EEG monitoring.
  
  
  RESULTS
  Ninety-eight children (53 males) with CSE (median age of 5 years) underwent subsequent continuous EEG monitoring after CSE. Electrographic seizures (with or without clinical correlate) were identified in 32 subjects (33%). Eleven subjects (34.4%) had electrographic-only seizures, 17 subjects (53.1%) had electroclinical seizures, and 4 subjects (12.5%) had an unknown clinical correlate. Of the 32 subjects with electrographic seizures, 15 subjects (46.9%) had electrographic status epilepticus. Factors associated with the occurrence of electrographic seizures after CSE were a previous diagnosis of epilepsy (P = .029) and the presence of interictal epileptiform discharges (P < .0005). The median (p25-p75) duration of stay in the pediatric intensive care unit was longer for children with electrographic seizures than for children without electrographic seizures (9.5 [3-22.5] vs 2 [2-5] days, Wilcoxon test, Z = 3.916, P = .0001). Four children (4.1%) died before leaving the hospital, and we could not identify a relationship between death and the presence or absence of electrographic seizures.
  
  
  CONCLUSIONS
  After CSE, one-third of children who underwent EEG monitoring experienced electrographic seizures, and among these, one-third experienced entirely electrographic-only seizures. A previous diagnosis of epilepsy and the presence of interictal epileptiform discharges were risk factors for electrographic seizures.
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Child Neurology, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain.
authors.forename: Iván
authors.initials: I
authors.lastname: Sánchez Fernández
authors.affiliation: Departments of Neurology and Pediatrics, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA. Electronic address: abend@email.chop.edu.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Abend
authors.affiliation: Department of Pediatrics, Oakland University William Beaumont School of Medicine, Royal Oak, MI; Department of Neurology, Oakland University William Beaumont School of Medicine, Royal Oak, MI.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Arndt
authors.affiliation: Department of Neurology, Children's National Medical Center, Washington, DC.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Carpenter
authors.affiliation: Division of Neurology, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Chapman
authors.affiliation: Division of Pediatric Neurology, Duke University Hospital and Duke University School of Medicine, Durham, NC.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Cornett
authors.affiliation: Departments of Neurology and Pediatrics, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Dlugos
authors.affiliation: Division of Pediatric Neurology, Duke University Hospital and Duke University School of Medicine, Durham, NC.
authors.forename: William B
authors.initials: WB
authors.lastname: Gallentine
authors.affiliation: Division of Neurology, Department of Pediatrics Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Giza
authors.affiliation: Division of Neurology, Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Joshua L
authors.initials: JL
authors.lastname: Goldstein
authors.affiliation: Division of Neurology, The Hospital for Sick Children and University of Toronto, Toronto, ON.
authors.forename: Cecil D
authors.initials: CD
authors.lastname: Hahn
authors.affiliation: Division of Neurology, Department of Pediatrics Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Lerner
authors.affiliation: Division of Neurology, Department of Pediatrics Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Joyce H
authors.initials: JH
authors.lastname: Matsumoto
authors.affiliation: Division of Neurology, The Hospital for Sick Children and University of Toronto, Toronto, ON.
authors.forename: Kristin
authors.initials: K
authors.lastname: McBain
authors.affiliation: Department of Neurology, University of California San Francisco, San Francisco, CA.
authors.forename: Kendall B
authors.initials: KB
authors.lastname: Nash
authors.affiliation: Division of Neurology, The Hospital for Sick Children and University of Toronto, Toronto, ON.
authors.forename: Eric
authors.initials: E
authors.lastname: Payne
authors.affiliation: Departments of Neurology and Pediatrics, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Sánchez
authors.affiliation: Department of Pediatrics, University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ.
authors.forename: Korwyn
authors.initials: K
authors.lastname: Williams
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013226:Status Epilepticus / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: CSE; Convulsive status epilepticus; EEG; Electroencephalogram