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Nonconvulsive status epilepticus in children: clinical and EEG characteristics.
Epilepsia. 2006 Sep; 47(9):1504-9.E

Abstract

BACKGROUND

Nonconvulsive status epilepticus (NCSE) is a highly heterogeneous clinical condition that is understudied in the pediatric population.

OBJECTIVE

To analyze the epidemiological, clinical, and electroencephalograpic features in pediatric patients with NCSE.

METHODS

We identified 19 pediatric patients with NCSE from the epilepsy database of the Comprehensive Epilepsy Center at, Columbia University between June 2000 and December 2003. Continuous electroencephalographic (EEG) monitoring was analyzed and chart review was performed.

RESULTS

The patients ranged from 1 month old to 17 years of age. Five patients developed NCSE following convulsive status epilepticus (CSE), and a further 12 patients developed NCSE after brief convulsions. Two developed NCSE as the first manifestation during a comatose state following hypoxic events. Acute hypoxic-ischemic injury was the most frequent etiology of NCSE in our population (5 of 19; 26%), followed by exacerbation of underlying neurometabolic disease (4 of 19; 21%), acute infection (3 of 19; 16%), change in antiepileptic drug regimen (3 of 19;16%), refractory epilepsy (2 of 19; 11%) and intracranial hemorrhage (2 of 19; 11%). Six patients had associated periodic lateralized epileptiform discharges (PLEDs), one had generalized periodic epileptiform discharges (GPEDs). Five (5 of 19; 26%) patients died of the underlying acute medical illness. Periodic discharges were associated with worse outcome.

CONCLUSION

The majority of our patients with NCSE had preceding seizures in the acute setting prior to the diagnosis of NCSE, though most of these seizures were brief, isolated convulsions (12 patients) rather than CSE (five patients). Prolonged EEG monitoring to exclude NCSE may be warranted in pediatric patients even after brief convulsive seizures. Prompt recognition and treatment may be necessary to improve neurological outcome.

Authors+Show Affiliations

Tay SK
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Hirsch LJ
No affiliation info available
Leary L
No affiliation info available
Jette N
No affiliation info available
Wittman J
No affiliation info available
Akman CI
No affiliation info available

MeSH

Age FactorsCerebral CortexChildChild, PreschoolComorbidityElectroencephalographyFemaleHumansInfantMaleMonitoring, PhysiologicSeizuresStatus Epilepticus

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16981867

Citation

Tay, Stacey K H., et al. "Nonconvulsive Status Epilepticus in Children: Clinical and EEG Characteristics." Epilepsia, vol. 47, no. 9, 2006, pp. 1504-9.
Tay SK, Hirsch LJ, Leary L, et al. Nonconvulsive status epilepticus in children: clinical and EEG characteristics. Epilepsia. 2006;47(9):1504-9.
Tay, S. K., Hirsch, L. J., Leary, L., Jette, N., Wittman, J., & Akman, C. I. (2006). Nonconvulsive status epilepticus in children: clinical and EEG characteristics. Epilepsia, 47(9), 1504-9.
Tay SK, et al. Nonconvulsive Status Epilepticus in Children: Clinical and EEG Characteristics. Epilepsia. 2006;47(9):1504-9. PubMed PMID: 16981867.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonconvulsive status epilepticus in children: clinical and EEG characteristics. AU - Tay,Stacey K H, AU - Hirsch,Lawrence J, AU - Leary,Linda, AU - Jette,Nathalie, AU - Wittman,John, AU - Akman,Cigdem I, PY - 2006/9/20/pubmed PY - 2006/10/21/medline PY - 2006/9/20/entrez SP - 1504 EP - 9 JF - Epilepsia JO - Epilepsia VL - 47 IS - 9 N2 - BACKGROUND: Nonconvulsive status epilepticus (NCSE) is a highly heterogeneous clinical condition that is understudied in the pediatric population. OBJECTIVE: To analyze the epidemiological, clinical, and electroencephalograpic features in pediatric patients with NCSE. METHODS: We identified 19 pediatric patients with NCSE from the epilepsy database of the Comprehensive Epilepsy Center at, Columbia University between June 2000 and December 2003. Continuous electroencephalographic (EEG) monitoring was analyzed and chart review was performed. RESULTS: The patients ranged from 1 month old to 17 years of age. Five patients developed NCSE following convulsive status epilepticus (CSE), and a further 12 patients developed NCSE after brief convulsions. Two developed NCSE as the first manifestation during a comatose state following hypoxic events. Acute hypoxic-ischemic injury was the most frequent etiology of NCSE in our population (5 of 19; 26%), followed by exacerbation of underlying neurometabolic disease (4 of 19; 21%), acute infection (3 of 19; 16%), change in antiepileptic drug regimen (3 of 19;16%), refractory epilepsy (2 of 19; 11%) and intracranial hemorrhage (2 of 19; 11%). Six patients had associated periodic lateralized epileptiform discharges (PLEDs), one had generalized periodic epileptiform discharges (GPEDs). Five (5 of 19; 26%) patients died of the underlying acute medical illness. Periodic discharges were associated with worse outcome. CONCLUSION: The majority of our patients with NCSE had preceding seizures in the acute setting prior to the diagnosis of NCSE, though most of these seizures were brief, isolated convulsions (12 patients) rather than CSE (five patients). Prolonged EEG monitoring to exclude NCSE may be warranted in pediatric patients even after brief convulsive seizures. Prompt recognition and treatment may be necessary to improve neurological outcome. SN - 0013-9580 UR - https://www.unboundmedicine.com/medline/citation/16981867/Nonconvulsive_status_epilepticus_in_children:_clinical_and_EEG_characteristics_ DB - PRIME DP - Unbound Medicine ER -