title: Cardiac injury after convulsive status epilepticus in children.
abstract: OBJECTIVE
  Convulsive status epilepticus (CSE) is a medical emergency with high mortality that usually occurs within 30 days following the seizure activity. One of the potential mechanisms contributing to mortality in this period following CSE is cardiac injury. The aim of the present study was to evaluate cardiac injury after CSE in children.
  
  
  METHODS
  Sixty children presented with CSE were enrolled in this study. Thirty healthy children with matched age and sex were taken as a control. Electrocardiogram (ECG), echocardiographic examinations, plasma concentration of cardiac troponin I (cTnI) and brain-type natriuretic peptide (BNP) were done 6 h after control of seizure for patients and control groups.
  
  
  RESULTS
  Thirty three patients were presented with CSE for the first time. ECG changes were present in 55% of patients with CSE in the form of conduction abnormalities, ischemic changes, and arrhythmias. Echocardiographic examinations revealed a significant increase in left ventricular end-diastolic dimension (LVEDD) and left ventricular end systolic dimension (LVESD) in patients with CSE than control group. Moreover, a significant decrease in LV systolic function and RV diastolic function were detected by tissue Doppler. The mean plasma concentrations of BNP and cTnI were significantly higher in patients with CSE than the control group (p value < 0.001). The overall mortality in our study was 8.3% (5/60); four of them had ECG changes. There was significant increase in duration of CSE, length of intensive care and hospital admission in CSE patients with ECG changes than those without ECG changes with p values 0.001, 0.031 and <0.001 respectively.
  
  
  CONCLUSIONS
  Cardiac injury in convulsive SE is common and may be under recognized. So, cardiac assessment should be a routine step in CSE patients' management.
authors.affiliation: Pediatric Department, Tanta University Hospital, Tanta, Egypt. Electronic address: doaamoha@yahoo.com.
authors.forename: Doaa
authors.initials: D
authors.lastname: El Amrousy
authors.affiliation: Pediatric Department, Tanta University Hospital, Tanta, Egypt. Electronic address: Maher_ahmed_2005@yahoo.com.
authors.forename: Maher
authors.initials: M
authors.lastname: Abd El-Hafez
authors.affiliation: Pediatric Department, Aswan University Hospital, Aswan, Egypt. Electronic address: dr_mohamed_nashat@yahoo.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Nashat
authors.affiliation: Clinical Pathology Department, Tanta University Hospital, Tanta, Egypt. Electronic address: hossamhodeib@gmail.com.
authors.forename: Hossam
authors.initials: H
authors.lastname: Hodeib
mesh_terms: D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000209:etiology* / Q000401:mortality; D006801:Humans; D013226:Status Epilepticus / Q000150:complications* / Q000401:mortality
keywords: Arrhythmias; BNP; Cardiac injury; Status epilepticus; Troponin