Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis

Detalhes bibliográficos
Autor(a) principal: Santos, Maria Inês
Data de Publicação: 2012
Outros Autores: Nzwalo, Hipólito, Monteiro, José Paulo, Fonseca, Maria José
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/61
Resumo: Background/Aims: status epilepticus (SE) is the most common neurological emergency in childhood. It may be associated with high mortality and morbidity, resulting in focal neurologic deficits, developmental disorder and epilepsy. The aims of this study were to describe the epidemiology, mortality and morbidity of convulsive SE and to assess the predictive factors of its neurological, cognitive and behavioral prognosis. Material and Methods: observational, retrospective, analytical study. Clinical files of children admitted to the Pediatric Emergency Department of Hospital Garcia de Orta with a diagnosis of convulsive SE between first January 2002 to 31st December 2006 were analyzed. The studied variables were age at crisis and current age, gender, type of seizure, duration and etiology of seizure, neurological deficit, epilepsy, seizures, psychomotor development and behavior. Regarding the last five variables data from before and after the SE were analyzed. Data analysis was performed with the programs Excel2007® and SPSS® 15.0. Results: 29 children were admitted with 33 episodes of SE aged between nine months and five years, there were no differences in gender distribution (male 12, female: 17 - p = 0.46). The etiology of SE was febrile in 16 children, remote symptomatic in seven related to idiopathic / cryptogenic epilepsy in five children and not classifiable in one case. The mean follow-up was six years and four months. There were no deaths associated with SE. There was deterioration in neurological status in two children (8.7%). Epilepsy was diagnosed following the SE in three (13%) children. Conclusions: This retrospective review suggests that the SE is associated with a better prognosis than that recorded a few decades ago. A more favorable prognosis was verified in febrile status than in other etiologies.
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spelling Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysisEstado de mal convulsivo na urgência pediátrica: estudo retrospectivo de cinco anosBackground/Aims: status epilepticus (SE) is the most common neurological emergency in childhood. It may be associated with high mortality and morbidity, resulting in focal neurologic deficits, developmental disorder and epilepsy. The aims of this study were to describe the epidemiology, mortality and morbidity of convulsive SE and to assess the predictive factors of its neurological, cognitive and behavioral prognosis. Material and Methods: observational, retrospective, analytical study. Clinical files of children admitted to the Pediatric Emergency Department of Hospital Garcia de Orta with a diagnosis of convulsive SE between first January 2002 to 31st December 2006 were analyzed. The studied variables were age at crisis and current age, gender, type of seizure, duration and etiology of seizure, neurological deficit, epilepsy, seizures, psychomotor development and behavior. Regarding the last five variables data from before and after the SE were analyzed. Data analysis was performed with the programs Excel2007® and SPSS® 15.0. Results: 29 children were admitted with 33 episodes of SE aged between nine months and five years, there were no differences in gender distribution (male 12, female: 17 - p = 0.46). The etiology of SE was febrile in 16 children, remote symptomatic in seven related to idiopathic / cryptogenic epilepsy in five children and not classifiable in one case. The mean follow-up was six years and four months. There were no deaths associated with SE. There was deterioration in neurological status in two children (8.7%). Epilepsy was diagnosed following the SE in three (13%) children. Conclusions: This retrospective review suggests that the SE is associated with a better prognosis than that recorded a few decades ago. A more favorable prognosis was verified in febrile status than in other etiologies.Introdução/Objectivos: O estado de mal epiléptico (EME) é a emergência neurológica mais comum na infância. Pode associar-se a mortalidade e morbilidade elevadas, traduzida em défices neurológicos focais, perturbação do desenvolvimento e epilepsia. Os objectivos deste estudo foram descrever a epidemiologia, a mortalidade e morbilidade do EME convulsivo e avaliar os fatores preditivos do seu prognóstico neurológico, cognitivo e comportamental. Material e Métodos: Estudo observacional, retrospectivo e analítico. Foram analisados os processos clínicos das crianças admitidas na Urgência Pediátrica do Hospital Garcia de Orta com diagnóstico de EME convulsivo entre um de Janeiro 2002 a 31 de Dezembro 2006. As variáveis estudadas foram: idade na crise e idade atual, sexo, tipo de crise epiléptica, duração e etiologia da crise epiléptica, défice neurológico, epilepsia, crises epilépticas, desenvolvimento psicomotor e comportamento. Relativamente às últimas cinco variáveis foram analisados os dados prévios e posteriores ao episódio de EME. O tratamento dos dados foi efectuado com os programas Excel2007® e SPSS 15.0®. Resultados: Foram admitidas 29 crianças, com 33 episódios de EME com idades compreendidas entre os nove meses e os cinco anos, não foram encontradas diferenças na distribuição entre sexos (masculino: 12; feminino: 17 – p = 0,46). A etiologia do EME foi febril em 16 crianças, sintomática remota em sete, relacionada com epilepsia idiopática/criptogénica em cinco crianças e não classificável em um caso. O tempo médio de seguimento foi de seis anos e quatro meses. Não se verificaram mortes associadas ao EME. Verificou-se deterioração do estado neurológico prévio em duas crianças (8,7%). Foi diagnosticada epilepsia subsequente ao EME em três (13%) crianças. Conclusões: Esta revisão retrospectiva sugere que o EME está associado a um melhor prognóstico do que o registado há algumas décadas atrás. Verificou-se uma evolução mais favorável no estado de mal febril relativamente às outras etiologias.Ordem dos Médicos2012-08-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/61oai:ojs.www.actamedicaportuguesa.com:article/61Acta Médica Portuguesa; Vol. 25 No. 4 (2012): July-August; 203-206Acta Médica Portuguesa; Vol. 25 N.º 4 (2012): Julho-Agosto; 203-2061646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/61https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/61/49Santos, Maria InêsNzwalo, HipólitoMonteiro, José PauloFonseca, Maria Joséinfo:eu-repo/semantics/openAccess2022-12-20T10:55:46Zoai:ojs.www.actamedicaportuguesa.com:article/61Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:21.721183Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis
Estado de mal convulsivo na urgência pediátrica: estudo retrospectivo de cinco anos
title Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis
spellingShingle Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis
Santos, Maria Inês
title_short Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis
title_full Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis
title_fullStr Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis
title_full_unstemmed Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis
title_sort Convulsive status epilepticus in the pediatric emergency department: five year retrospective analysis
author Santos, Maria Inês
author_facet Santos, Maria Inês
Nzwalo, Hipólito
Monteiro, José Paulo
Fonseca, Maria José
author_role author
author2 Nzwalo, Hipólito
Monteiro, José Paulo
Fonseca, Maria José
author2_role author
author
author
dc.contributor.author.fl_str_mv Santos, Maria Inês
Nzwalo, Hipólito
Monteiro, José Paulo
Fonseca, Maria José
description Background/Aims: status epilepticus (SE) is the most common neurological emergency in childhood. It may be associated with high mortality and morbidity, resulting in focal neurologic deficits, developmental disorder and epilepsy. The aims of this study were to describe the epidemiology, mortality and morbidity of convulsive SE and to assess the predictive factors of its neurological, cognitive and behavioral prognosis. Material and Methods: observational, retrospective, analytical study. Clinical files of children admitted to the Pediatric Emergency Department of Hospital Garcia de Orta with a diagnosis of convulsive SE between first January 2002 to 31st December 2006 were analyzed. The studied variables were age at crisis and current age, gender, type of seizure, duration and etiology of seizure, neurological deficit, epilepsy, seizures, psychomotor development and behavior. Regarding the last five variables data from before and after the SE were analyzed. Data analysis was performed with the programs Excel2007® and SPSS® 15.0. Results: 29 children were admitted with 33 episodes of SE aged between nine months and five years, there were no differences in gender distribution (male 12, female: 17 - p = 0.46). The etiology of SE was febrile in 16 children, remote symptomatic in seven related to idiopathic / cryptogenic epilepsy in five children and not classifiable in one case. The mean follow-up was six years and four months. There were no deaths associated with SE. There was deterioration in neurological status in two children (8.7%). Epilepsy was diagnosed following the SE in three (13%) children. Conclusions: This retrospective review suggests that the SE is associated with a better prognosis than that recorded a few decades ago. A more favorable prognosis was verified in febrile status than in other etiologies.
publishDate 2012
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publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 25 No. 4 (2012): July-August; 203-206
Acta Médica Portuguesa; Vol. 25 N.º 4 (2012): Julho-Agosto; 203-206
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