title: Seizures in a Pediatric Intensive Care Unit: A Prospective Study.
abstract: BACKGROUND
  The aim of the research is to determine the etiology and clinical features of seizures in critically ill children admitted to a pediatric intensive care unit (PICU).
  
  
  METHODS
  A total of 203 children were admitted from June 2013 to November 2013; 45 patients were eligible. Age ranged from 2 months to 19 years. Seizures were organized as epileptic or acute symptomatic. Pediatric risk of mortality score III, Glasgow coma scale, risk factors, coexistent diagnosis, medications administered before admission, type and duration of seizures, drugs used, requirement and duration of mechanical ventilation, length of stay and neuroimaging findings were collected as demographic data prospectively.
  
  
  RESULTS
  The male-female ratio was 0.8. Mean age was 5.4. The most common causes of seizures were acute symptomatic. Most frequent coexistent diagnosis was infectious diseases, and 53.3% had recurrent seizures. Medications were administered to 51.1% of the patients before admission. Seizures were focal in 21 (46.7%), generalized in 11 (24.4%) and 13 (28.9%) had status epilepticus. Intravenous midazolam was first-line therapy in 48.9%. Acute symptomatic seizures were usually new-onset, and duration was shorter. Epileptic seizures tended to be recurrent and were likely to progress to status epilepticus. However, type of seizures did not change severity of the disease. Also, laboratory test results, medications administered before admission, requirement and duration of ventilation, mortality and length of stay were not significant between epileptic/acute symptomatic patients.
  
  
  CONCLUSIONS
  Seizures in critically ill children, which may evolve into status epilepticus, is an important condition that requires attention regardless of cause. Intensified educational programs for PICU physicians and international guidelines are necessary for a more efficient approach to children with seizures.
authors.affiliation: Pediatric Intensive Care Unit, Ankara Children's, Hematology Oncology Education and Research Hospital, Ankara, 06110 Turkey sanliay@yahoo.com.
authors.forename: Sanliay
authors.initials: S
authors.lastname: Sahin
authors.affiliation: Pediatric Intensive Care Unit, Hacettepe University School of Medicine, Ankara, 06110 Turkey.
authors.forename: Mutlu Uysal
authors.initials: MU
authors.lastname: Yazici
authors.affiliation: Pediatric Intensive Care Unit, Ankara Children's, Hematology Oncology Education and Research Hospital, Ankara, 06110 Turkey.
authors.forename: Ganime
authors.initials: G
authors.lastname: Ayar
authors.affiliation: Pediatric Neurology Division, Ankara Children's, Hematology Oncology Education and Research Hospital, Ankara, 06110 Turkey.
authors.forename: Zeynep Selen
authors.initials: ZS
authors.lastname: Karalok
authors.affiliation: Pediatric Neurology Division, Gazi University School of Medicine, Ankara, 06110 Turkey.
authors.forename: Ebru Petek
authors.initials: EP
authors.lastname: Arhan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000150:complications* / Q000453:epidemiology; D016638:Critical Illness; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D012121:Respiration, Artificial; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology / Q000209:etiology*; D017678:Sex Distribution; D013226:Status Epilepticus / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: children; critically ill; mechanical ventilation; pediatric intensive care unit; seizures