To Study Clinical Profile and Short-Term Outcome of Pediatric Status Epilepticus at a Tertiary-Care Center in Central India
Author(s): Paromita Roy and Saptarishi Bose*
Abstract
Objective: To assess clinical profile and short term treatment outcomes of pediatric status epilepticus (SE) at a tertiary - care center in central India Methods: Prospective observational study. All Patients between age of 01month to 14 year presented as status epilepticus were managed as per IAP protocol of status epilepticus and, data was collected after taking written consent. They were studied for clinical presentation, efficacy of management and short-term outcome. Results: In our study on maximum age group children between 1-5 year i.e. 72 (68.57%). followed by >5-14 year were i.e. 21(20%) and <12month were 12(11.4%). Preponderance of male 55(52.4%) over female child 50(47.6 %) was observed. Most of 70.5% children present GTCS type of seizure on admission. Most of the cases CNS infections were predominant. In our study, presence of fever was documented in 85 subjects out of 105 cases. Our Study short term overall mortality rate was found to be 20(19) % child. Out of these 17(85 %) deaths belongs to the infectious etiology. Study was found that these 20 children mortality 17 (27.4%) mortality was these children where time taken to controlled seizure(>30 min).and those children start the management delay. in our study maximum number of subjects for termination of seizure lorazepam 65.7 %used as first line and in the remaining 36(34.3%) subjects midazolam was used In our study univariate analysis showed factors associated with a high risk of mortality in status epilepticus are prolonged duration of seizures (p- value, 0.015) time taken to control seizures (p-value <0.0001) nutritional status (p-value 0.008)We conclude that rapid termination of seizure important steps to good outcome in term of mortality and morbidity in SE. Conclusions: Acute symptomatic etiology, mainly acute CNS infections, is the leading cause of SE in this region. Early and pre-hospital management with benzodiazepines may improve SE outcome. Prolong duration of seizures and not respond to AED were major contributing factors in our study. All efforts to make to diagnose status epilepticus, so that we control seizure early by no delay for treatment.