Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study
Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study
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DOI：
10.1016/s0140-6736(06)69043-0
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发表时间：
2006-07-15
期刊：
影响因子：
168.9
通讯作者：
Scott, Rod C.
中科院分区：
文献类型：
--
作者：
Chin, Richard F. M.;Neville, Brian G. R.;Scott, Rod C.
背景惊厥性癫痫持续状态是儿童最常见的神经内科急症，其发病率和死亡率都很高。这种疾病的大多数数据主要来自成年人，可能与儿童无关。因此，我们开展了北伦敦儿童癫痫持续状态监测研究（NLSTEPSS）：一项前瞻性、基于人群的儿童惊厥癫痫持续状态研究，以获得独特的儿科视角。方法通过覆盖目标人群的临床网络获得伦敦北部儿童癫痫持续状态发作的临床和人口学数据。我们从标准化入学表格的匿名副本中获得这些数据；事故和急诊、护理、救护车和重症监护室记录；以及对父母、医疗人员、护理人员和护理人员的采访。我们使用捕获-再捕获模型来调查确定。结果在226名儿童中，176名有惊厥性癫痫持续状态的首次发作。我们估计确定率在62%到84%之间。经确定调整后的发病率为每年每10万人17 - 23例。98例（56%,95% CI 48-63）患儿在首次发作前神经系统健康，其中56例（57%,47-66）患儿有长时间发热性癫痫发作。11例（12%,6-18）首次出现热惊厥癫痫持续状态的儿童患有急性细菌性脑膜炎。保守估计1年惊厥癫痫持续状态复发率为16%（10-24%）。病死率为3%（2-7%）。解释惊厥性癫痫持续状态在儿童期更为常见，其病因范围不同，死亡风险低于成人。这些儿科数据将有助于告知抽搐癫痫持续状态的管理和适当分配资源，以减少这种疾病在儿童时期的影响。
Background Convulsive status epilepticus is the most common childhood medical neurological emergency, and is associated with significant morbidity and mortality. Most data for this disorder are from mainly adult populations and might not be relevant to childhood. Thus we undertook the North London Status Epilepticus in Childhood Surveillance Study (NLSTEPSS): a prospective, population-based study of convulsive status epilepticus in childhood, to obtain a uniquely paediatric perspective.Methods Clinical and demographic data for episodes of childhood convulsive status epilepticus that took place in north London were obtained through a clinical network that covered the target population. We obtained these data from anonymised copies of a standardised admission proforma; accident and emergency, nursing, ambulance, and intensive-care unit notes; and interviews with parents, medical, nursing, and paramedic staff. We investigated ascertainment using capture-recapture modelling.Findings Of 226 children enrolled, 176 had a first ever episode of convulsive status epilepticus. We estimated that ascertainment was between 62% and 84%. The ascertainment-adjusted incidence was between 17 and 23 episodes per 100000 per year. 98 (56%, 95% CI 48-63) children were neurologically healthy before their first ever episode and 56 (57%, 47-66) of those children had a prolonged febrile seizure. 11 (12%, 6-18) of children with first ever febrile convulsive status epilepticus had acute bacterial meningitis. Conservative estimation of 1-year recurrence of convulsive status epilepticus was 16% (10-24%). Case fatality was 3% (2-7%).Interpretation Convulsive status epilepticus in childhood is more common, has a different range of causes, and a lower risk of death than that in adults. These paediatric data will help inform management of convulsive status epilepticus and appropriate allocation of resources to reduce the effects of this disorder in childhood.