Electrographic Seizures after Convulsive Status Epilepticus in Children and Young Adults: A Retrospective Multicenter Study

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• 作者：Iv谩n S谩nchez Fern谩ndez ; Nicholas S. Abend ; Daniel H. Arndt ; Jessica L. Carpenter ; Kevin E. Chapman ; Karen M. Cornett ; Dennis J. Dlugos ; William B. Gallentine ; Christopher C. Giza ; Joshua L. Goldstein ; Cecil D. Hahn ; Jason T. Lerner ; Joyce H. Matsumoto ; Kristin McBain ; Kendall B. Nash ; Eric Payne ; Sarah M. S谩nchez ; Korwyn Williams ; Tobias Loddenkemper
• 关键词：CSE ; Convulsive status epilepticus ; EEG ; Electroencephalogram
• 刊名：The Journal of Pediatrics
• 出版年：February, 2014
• 年：2014
• 卷：164
• 期：2
• 页码：339-346.e2
• 全文大小：191 K

文摘

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Objective

To describe the prevalence, characteristics, and predictors of electrographic seizures after convulsive status epilepticus (CSE).

Study design

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聽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聽epilepsy and the presence of interictal epileptiform discharges were risk factors for electrographic seizures.