Abstract

Aim: Status epilepticus (SE) is among the most common neurological ernergencies in childhood with significant morbidity and mortality risks. In this study, we investigated etiology, clinical presentation and risk factors of SE in pediatric age group prospectiuely. Methods: A total of 52 patients (mean age 38.46 ± 39.06 months) consisted of 22 girls (42.3%) and 30 boys (57.7%) who w ere hospitalized in Izmir Behçet Uz Children's Research and Education Hospital between October 2005-March 2006 were included in the study. All cases were evaluated in respect to age, sex, duration of SE, type of seizure, etiological factors and neurologic examination findings. Student t-test and Fisher-exact test were applied for statistical analysis. All statistical analyses were made ıvith SPSS 12.0 software. Results: There were 34 (%65.4) one-year-old and younger cases. Durations of status epilepticus were 30-60 min, and longer than 60 min in 30 (57.6%) and 22 (42.4%) cases, respectively. Types of seizure were convulsive and non-convulsive in 48 (92.3%) and 4 (7.6%) patients, respectively; subtypes included tonic-clonic, tonic, myoclonic, and clonic in 36 (69.2%), 6 (11.5%), 4 (7.6%), and 2 (3.8%) patients, respectively. Generalized and partial epilepsy w ere observed in 82.6%o and 16.4%) of the patients, respectively. Half of all patients had been diagnosed epilepsy and presented with SE. SE was seen in 15 (%57,7) cases 12 months later after the epilepsy diagnosis. Six (11.6%) patients had had febrile convulsions previously Abnormal neurological examination and mental retardation were detected in 41 (78.8%) and 28 (53.8%) patients, respectively. Etiology was symptomatic in 46 (88.4%) patients, and cryptogenic in 6 (11.4%o) patients. Twelve patients (23%) used only one drug, while 14 (%54) patients were on polypharmacy. Seizures were controlled by phenytoin in 46.1%, midazolam in 36.5%, pentobarbital in 5.7%, propofol in 7.6%o, and intravenous valproat in 3.8% of patients. Anesthesia (midazolam, pentobarbital, propofol) was used in 26 patients. Mortality rate was 7.6%. In patient groups which presented with SE, mental retardation rate vuas significantly higher in patient group who had epilepsi priorly when compared with patients who were not previously diagnosed as epilepsi (p<0.001). Conclusion: During the childhood, SE is observed more commonly during the onset of epilepsy; in children with younger ages; and in those with symptornatic etiologies and that accompanying mental retardation is significantly more common in patients who already had diagnosed as epilepsy. We conclude that patients with those features should be followed more closely.