Abstract
Status epilepticus (SE) in children is the most common neurological emergency in pediatric emergency medicine, this condition poses a risk to the child’s life and requires early recognition and treatment to interrupt the crisis and thus to avoid the hemodynamic consequences, systemic complications and subsequent neurological deterioration.
The epidemiology, etiology and prognosis are different from those observed in adults. This paper discusses in detail issues such as: epidemiology, classification, etiology, diagnostic approach and treatment of status epilepticus the role of new antiepileptic drugs and other therapeutic options, including the role of epilepsy surgery in refractory SE. Finally the most important aspects pertaining the outcome of children with SE.
References
RIVIELLO JJ. Status Epilepticus in Children. In Drislane FW ed. Current Clinical Neurology: Status Epilepticus: A Clinical Perspective. Otawa, NJ Humana Press Inc.,. 2007; 16: 313-38.
SINGH R, GAILLARD W. Status epilepticus in Children. Current Neurology and Neuroscience Reports 2009; 9:137–44.
International League Against Epilepsy, Commis- sion Epidemiology and Prognosis. Guidelines for epidemiologic on studies on epilepsy. Epilepsia 1993; 34: 592–6.
RIVIELLO JJ, ASHWAL S, HIRTZ D, ET AL. Practice Parameter: Diagnostic assessment of the child with status epilepticus (an evidence-based review) Report of the Quality Standards Subcommit- tee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2006; 67:1542–1550.
NEVILLE BG, CHIN RF, SCOTT RC. Childhood convulsive status epilepticus: epidemiology, manage- ment and outcome. Acta Neurol Scand 2007; 115:21-4.
BLUME WT, LUDERS HO, MIZRAHI E, TASSI- NARI C, VAN EMDE BW, ENGEL J JR. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminol- ogy. Epilepsia 2001; 42:1212–8.
LOWENSTEIN DH, BLECK T, MACDONALD RL. It’s time to revise the definition of status epilep- ticus. Epilepsia 1999; 40:120–2.
SHINNAR S, BERG AT, MOSHÉ SL, SHINNAR R. How long do new onset seizures in children last? Ann Neurol. 2001;49: 659-64.
WALKER M, CROSS H, SMITH S, ET AL. Non- convulsive status epilepticus: Epilepsy Research Foundation workshop reports. Epileptic Disord 2005; 7: 253-96.
CHIN RF, NEVILLE BG, PECKHAM C, ET AL.: Incidence, cause, and short-term outcome of con- vulsive status epilepticus in childhood: prospective population-based study. Lancet 2006; 368:222–9.
NISHIYAMA I, OHTSUKA Y, TSUDA T, ET AL.: An epidemiological study of children with status epi- lepticus in Okayama, Japan. Epilepsia 2007; 48:1133– 7.
WU YW, SHEK DW, GARCÍA PA, ET AL. Inci- dence and mortality of generalized convulsive status epilepticus in California. Neurology 2002; 58: 1070-6.
RASPALL-CHAURE M, CHIN R, NEVILLE B, ET AL. The Epidemiology of Convulsive Status Epilepticus in Children: A Critical Review. Epilepsia, 2007;48:1652–63.
CHIN RF, NEVILLE BG, PECKHAM C, BEDFORD H, WADE A, SCOTT RC, FOR THE NLSTEPSS COLLABORATIVE GROUP. Socioeco- nomic deprivation independent of ethnicity increases the risk of convulsive status epilepticus in childhood. Epilepsia 2006; 47(Suppl. 3): 7.
SINGH RK, STEPHENS S, BERL MM, ET AL. Prospective study of new-onset seizures present- ing as status epilepticus in childhood. Neurology 2010;74:636–42
VERITY CM AND ROSS EM, GOLDING J. Out- come of childhood status epilepticus and lengthy febrile convulsions: findings of national cohort study. British Medical Journal 1997; 307:225–8.
BERG AT, SHINNAR S, TESTA FM. Status epi- lepticus in children with newly diagnosed epilepsy. Ann Neurol 1999;45:618-23.
BERG AT, SHINNAR S, LEVY SR, ET AL. Satus epilepticus after the initial diagnosis of epilepsy in Children. Neurology 2004;63:1027-34.
DUGLOS D. Medical Treatment of Pediatric Status Epilepticus. Semin Pediatr Neurol 2010;17:169- 175.
BASU H, O’CALLAGHAN F. Status epilepticus: Beyond guidelines. Current Paediatrics 2005;15: 324-32.
SHORVON S. What is nonconvulsive status epi- lepticus and what are its subtypes? Epilepsia 2007: 48 (Suppl. 8): 35–8.
STATLER KD, VAN ORMAN CD. Status Epi- lepticus. In Nichils DG, Ed. Roger’s Textbook of Pediatric Intensive Care. Philadelphia, PA: Lippincott Williams & Wilkins; 2008:912-928.
WATEMBERG N, SEGAL G. A suggested approach to the Etiologic Evaluation of Status Epilepticus in Children: What to Seek after the usual causes have been ruled out. J Child Neurol 2010;25:203-11.
ALLDREDGE BK, WALL DB, FERRIERO DM: Effect of prehospital treatment on the outcome of status epilepticus in children. Pediatr Neurol 1995; 12:213-6.
CHIN R, SCOTT R. Status Epilepticus. In Wheeler D.S. et al. (eds.), The Central Nervous System in Pediatric Critical Illness and Injury, Springer-Verlag, London, 2009: 117-129.
GLAUSER TA: Designing practical evidence- based treatment plans for children with prolonged seizures and status epilepticus. J Child Neurol 2007;22: 38S-46S .
ABEN NS, GUTIERREZ-COLINA AM, DUGLOS DJ. Medical treatment of Pediatric Status epilepticus. Semin Pediatr Neurol 2010; 17:169-175.
SHORVON S. BAULAC M, CROSS H, ET AL. The drug treatment of status epilepticus in europe. Consensus document from a workshop at the first London colloquium on status epilepticus. Epilepsia 2008;49: 1277-86.
HUBERT P, PARAIN D, VALLÉE L. Manage- ment of convulsive status epilepticus in infant and children. Réanimation 2009; 18: 92—8.
ABEND N. HUH H, HELFAER M, DUGLOS D. Anticonvulsant medications in the pediatric emer- gency room and intensive care unit. Pediatr Emer Care 2008; 24:705-18.
YOSHIKAWA H, YAMAZAKI S, ABE T, ODA Y. Midazolam as a first-line agent for status epilepticus
in children. Brain Dev 2000; 22: 239-42.
JELINEK GA, GALVIN GM. Midazolam and status epilepticus in children. Crit Care Med 1994; 22:1340.
ABEND N, MONK HIntravenous levetiracetam in critically ill children with status epilepticus or acute repetitive seizures. Pediatr Crit Care Med 2009; 10:505–10.
GALLENTINE W, HUNNICUTT AS, HUSAIN AM: Levetiracetam in children with refractory status epilepticus. Epilepsy Behav 2009;14:215-8.
KIRMANI BF, CRISP ED, KAYANI S, ET AL: Role of intravenous levetiracetam in acute seizure management of children. Pediatr Neurol 2009;41:37-9.
SAHIN M, MENACHE C, HOLMES G, ET AL. Outcome of severe refractory status epilepticus in children. Epilepsia 2001;42:1461-7.
HANHAN US, FIALLOS MR, ORLOWSKI JP. Status epilepticus in children. Pediatr Clin North Am 2001; 48:683-94.
KOUL R, CHACKO A, JAVED H, AL RIYAMI
K. Eight-year study of childhood status epilepticus: midazolam infusion in management and outcome. J Child Neurol. 2002; 17:908-10.
PELLOCK JM. Use of midazolam for refractory status epilepticus in pediatric patients. J Child Neurol. 1998;13:581-7.
HOLMES GL, RIVIELLO JJ JR. Midazolam and pentobarbital for refractory status epilepticus. Pediatr Neurol. 1999; 20:259-64.
LAMPIN M, DORKENOO A, LAMBLING M, ET AL. Use of midazolam for refractory status epilepti- cus in children. Revue Neurologique 2010; 166: 648-52.
CLAASSEN J, HIRSCH LJ, EMERSON RG, MAYER SA. Treatment of refractory status epilep- ticus with pentobarbital, propofol, or midazolam: a systematic review. Epilepsia. 2002; 43:146-53.
PERRY MS, HOLT PJ, SLADKY JT. Topiramate loading for refractory status epilepticus in children. Epilepsia 2006; 47:1070- 1.
KAHRIMAN M, MINECAN D, KUTLUAY E, SELWA L, BEYDOUN A. Efficacy of topiramate in children with refractory status epilepticus. Epilepsia 2003; 44:1353- 6.
OZDEMIR D, GULEZ P, URAN N, ET AL. Effi- cacy of continuous midazolam infusion and mortal- ity in childhood refractory generalized convulsive status epilepticus. Seizure 2005; 14: 129-32.
KINOSHITA H, NAKAGAWA E, IWASAKI Y, ET AL. Pentobarbital therapy for status epilepticus in children: timing of tapering. Pediatr Neurol. 1995; 13:164-8.
PRASAD A, WORRALL BB, BERTRAM EH, BLECK TP. Propofol and midazolam in the treat- ment of refractory status epilepticus. Epilepsia. 2001; 42:380-6.
MIRSATTARI SM, SHARPE MD, YOUNG B: Treatment of refractory status epilepticus with inha- lational anesthetic agents isoflurane and desflurane. Arch Neurol 2004, 61:1254–9
SCOTT R. NEVILLE B. Pharmacological man- agement of convulsive status in children. Dev Med Child Neurol 1999, 41: 207–10.
ZAWADRI I, STAFSTROM C. Status Epilepticus Treatment and outcome in Children: What Might the Future Hold?. Semin Pedatr Neurol 2010;17: 201-5.
MEWAINGH L, SEKHARA T, AEBY L, CHRIS- TIAENS F, DAN B. Oral ketamine in paediatric non- convulsive status epilepticus Seizure 2003; 12: 483–9.
KORFF C, NORDLI D. Diagnosis and manage- ment of nonconvulsive status epilepticus in children. Nature Clin Practice 2007; 3: 505-16.
ABEND N, DLUGOS D. Nonconvulsive status epileptic in a pediatric intensive care unit. Pediatr Neurol 2007; 37:165-70.
AKMAN C. Nonconvulsive Status Epileptic and continuos spike and Slow Wave of sleep in Children. Semin Ped Neurol 2010; 17:155-62.
ALEXOPOULUS A, LACHHWANI DK, GUPTA A, KOTAGAL P, HARRISON AM, BINGAMAN W. Resective surgery to treat refractory status epilepticus in children with focal epileptogenesis. Neurology 2005; 64:567–70.
LHATOO S. ALEXOPOULUS A. The sur- gical treatment of status epilepticus. Epilepsia, 2007;48(Suppl. 8):61–5,
VENDRAME M, LODDENKEMPER T. Surgical Treatment of Refractory Status Epilepticus in Children: Candidate Selection and Outcome. Semin Pediatr Neurol 2010;17:182-9.
FREITAG H, TUXHORN I. Cognitive function in preschool children after epilepsy surgery: Rationale for early intervention. Epilepsia 2005; 46:561-7.
KELLINGHAUS C., BERNING S, BESSELMAN M. Intravenous lacosamide as successful treatment for nonconvulsive status epilepticus after failure of first-line therapy. Epilepsy & Behavior 2009; 14:429- 31.
WHELESS J. The Safety of Intravenous Lacosamide. http://clinicaltrials.gov/ct2/show/ NCT00832884
WHELESS J, Treatment of Refractory Convul- sive Status Epilepticus in Children: Other Therapies. Semin Pediatr Neurol 2010; 17:190-4.
WASTERLAIN CG AND SHIRASAKA Y. Seizures, brain damage and brain development. Brain Develop- ment 1994; 16:279–85.
LEPPIK IE. Status epilepticus. In Wyllie E (ed): “The Treatment of Epilepsy: Principles and Prac- tice.” Philadelphia: Lea & Febiger, 1993: 678–85.
DE LORENZO ET AL, Epidemiology of Status Epilepticus. J Clin Neurophysiol 1.995; 12: 316-25.
HUSEIN N, APPLETON R, THORBURN K. Aetiology, course and outcome of children admitted to paediatric intensive care with convulsive status epi- lepticus. A retrospective 5-year review. Seizure 2007; 16:305-12.
RASPALL-CHAURE M, CHIN RF, NEVILLE BG, SCOTT RC. Outcome of paediatric convulsive status epilepticus: a systematic review. Lancet Neurol 2006; 5:769–779.
OSTROWSKY K, ARZIMANOGLOU A. Outcome and Prognosis of Status Epilepticus in Children. Semin Pediatr Neurol 2010; 17:195-200.
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