Khalid Ahmed, Sidra Kaleem Jafr, Faria Bhatti, Arshad Rafique, Anwarul Haque.
Clinical profile and outcome of children admitted with status epileptics in PICU of a developing country.
Pak J Neurological Sci Jan ;8(2):1-6.

Background: Status epilepticus (SE) is a common, life-threatening neurologic disorder. The exact incidence is not known. The frequency of occurrence of status epilepticus is 17-23 per 100, 000 persons per year, with the higher incidences occurring in developing countries. In children the mortality from SE ranges from 3-10%. Objective: To describe the etiology, clinical profile and immediate-outcome of children with status epilepticus at a Tertiary Care Hospital in Karachi. Method: This is a descriptive and retrospective cohort study on all children admitted in our institution with diagnosis of status epileptics (ICD 9 code 3453). Demographic, pertinent clinical variables and outcomes were collected on structured questionnaire. Result: During the study period, fifty patients were identified. Mean age was 51 months (age range was 1-168 months with SD± 41 months).There were 29 male: and 21 female. Generalized tonic clonic seizures were the most common (86%) form of seizures observed. Twenty- five (50%) patients were newly diagnosed with no prior history of seizure. Acute febrile illness or infections were the most common etiology (52%). No biochemical abnormalities were observed in our study. Abnormal EEG was reported in 62% of patients. CSF abnormalities were observed in 22%. Minimum 2 and maximum 8 anti-epileptic drugs were used (mean= 4.33). The most commonly parenteral drugs included phenytoin, phenobarbitone, levetiracetam and valproic acid. Thirty- one (62%) patients required continuous midazolam infusion. In majority (44%), status was controlled after more than 60mins.Thirty-three patients (66%) required PICU admission for seizure control. Thirty one (62%) required mechanical ventilation, twenty five (50%) required inotropic support. Mean PICU stay duration was 3.89 days (range=1-15 days). Survival rate was 92%. The cause of death (n=4) was related to underlying systemic illness. No complications were observed in forty-one (82%) patients. Conclusion: In our report, young children had a high incidence of SE and the most common etiology was acute febrile illness. Majority of cases were refractory SE although the mortality rate was low.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com