Aetiology, course and outcome of children admitted to paediatric intensive care with convulsive status epilepticus: A retrospective 5-year review
Aetiology, course and outcome of children admitted to paediatric intensive care with convulsive status epilepticus: A retrospective 5-year review
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DOI：
10.1016/j.seizure.2007.01.007
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发表时间：
2007-06-01
影响因子：
3
通讯作者：
Thorburn, Kent
中科院分区：
文献类型：
--
作者：
Hussain, Nahin;Appleton, Richard;Thorburn, Kent
对1999年1月至2004年4月间大型儿科重症监护病房(PICU)收治的癫痫持续状态(CSE)患儿的病因和病程进行了回顾性病例研究。癫痫持续状态被定义为持续(>；30分钟)强直-阵挛发作，无论癫痫发作是否在进入PICU之前已经停止。在此期间，137名(74名配偶)1个月至15岁的儿童住进了PICU，有147次癫痫持续状态。137名儿童中有47名(34%)在长期发烧发作后入院。在137名儿童中，38名(28%)有CSE的远期症状原因，24名(18%)因急性症状原因入院，15名(11%)因先前存在的特发性/隐源性癫痫急性加重入院。6名儿童患有进行性脑病，137名儿童中的其余7名(5%)没有找到病因。137名儿童中有49名(36%)曾有癫痫史。CSE平均持续时间为44min。在PICU接受苯二氮卓类药物与苯巴比妥或苯妥英联合治疗的儿童中，有49名(36%)需要进一步治疗以终止CSE发作。其中42例用硫喷妥钠麻醉，其余7例用咪达唑仑持续输注，均成功终止状态，无一例死亡。在入院前被认为是神经学和发育正常的70名儿童中，在最近一次随访时，只有1名儿童表现出新的严重神经异常。7名患者(5%)出现新的或新发的癫痫。(C)2007年英国癫痫协会。爱思唯尔有限公司出版。保留所有权利。
A retrospective case note study of the aetiotogy and course of children in convulsive status epilepticus (CSE) admitted to a large paediatric intensive care unit (PICU) was undertaken between January 1999 and April 2004. Status epilepticus was defined as a prolonged (>30 min) tonic-clonic seizure irrespective of whether the seizure had stopped prior to admission to PICU. During this period, 137 (74 mate) children aged 1 month to 15 years were admitted to PICU with 147 episodes of status epilepticus. Forty-seven of the 137 children (34%) were admitted following a prolonged febrile seizure. Thirty-eight of the 137 children (28%) had a remote symptomatic cause for the CSE, 24 (18%) were admitted for an acute symptomatic cause and 15 (11%) were admitted with an acute exacerbation of a pre-existing idiopathic/cryptogenic epilepsy. Six children had a progressive encephalopathy and no cause was identified in the remaining 7 of the 137 children (5%). Forty-nine (36%) of the 137 children had pre-existing epilepsy. The mean duration of CSE was 44 min. Forty-nine (36%) children admitted to PICU who had received a benzodiazepine with either phenobarbital or phenytoin, required further treatment to terminate the presenting episode of CSE. Forty-two of these 49 were treated with thiopentone anaesthesia and the remaining 7 with a continuous infusion of midazolam, successfully terminating status in all No child died. Of the 70 children considered to be previously neurologically and developmentally normal prior to admission, only 1 child demonstrated a new gross neurological abnormality at the time of latest follow-up. Seven patients (5%) developed new or de novo epilepsy. (c) 2007 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.