DW: Status epilepticus in children: etiology, clinical features, and outcome

Between August 1984 and September 1986, data were gathered prospectively on 114 episodes of convulsive status epi-lepticus, defined as seizure duration longer than 30 minutes, affecting 97 children. Status epilepticus was symptomatic in 72 % (chronic 59%, acute 13%) and idiopathic or febrile in 28%. We identified precipitating factors in 63 % of episodes. The most common factors were inadequate blood levels of anticonvulsants (32 of 60 episodes in children with prior seizures) and febrile illnesses, excluding meningitis or encephalitis (38 of 114 episodes). There was an elevated peripheral white blood cell count in 60%, acidosis with a pH of <7.0 in 12.5%, and cerebrospinal fluid pleocytosis not due to meningitis or encephalitis in 8 of 64 episodes. Eight children died, three with severe pre-existing brain damage, two with meningitis, and two with a poorly defined encephalopathy. Eighteen children developed a new neurologic deficit. Outcome was associated with the etiology and duration of status epilepticus, with age at the time of status a minor factor. A permanent deficit occurred in only five children with idiopathic or febrile status epilepticus. (J Child Neurol 1988;3:167-173). Status epilepticus is defined as persistentseizure activity or recurrent seizures without return of consciousness. Part of the definition is a duration of at least 30 minutes. Most series have dealt with status epilepticus in adults or have addressed specific problems associated with status epilepticus. Relatively few studies have dealt with the clinical aspects of status epilepticus in childhood. 1,2 The pur-pose of this study is to help clarify the clinical features of convulsive status epilepticus in childhood. We collected information on the etiology, precipitating factors, clinical and laboratory features, and outcome of convulsive status epilepticus of children seen pro-spectively during a two-year period