بررسي تشنج پايدار در بيماران بستري شده در بخش مراقبت هاي ويژه كودكان بيمارستان حضرت رسول اكرم (ص )

Evaluation of Status Epilepticus in Patients Admitted to the Pediatric Intensive Care Unit of Rasool Akram Hospital

Abstract Background & Aim: Status epilepticus(SE) is the most common neurological emergency in childhood. Cases referred to pediatric intensive care uriits(PICU) are the most severely affected. Thus, data from admissions to PICU for SE may provide some insight for devlopment of stategies to reduce the severity and complications of the situation. We conducted this study to determine etiology, factors influencing the occurrence of SE and mortality of patients. Patients and Methods: In a descriptive, cross sectional retrospective study files of 134 children(aged 1 month to 12 years) were reviewed; Age, etiology of SE, factors predesposing to occurrence of SE(e.g. previous neurological abnormality), course of the disease and mortality of patients were determined. Descriptive(mean±SD) and comprehensive statistics^ analysis) were used. P<0.05 was considered significant. Results: The mean age of patients was 4.8±4.5yr. Status epilepticus was most common in younger children with 45% of cases occurring in those younger than 2 years. 115(85%) out of 134 patients were admitted with their first episode of SE, while 19(15%) presented with recurrence. The most common etiology group was acute symptomatic(27.7%) whereas, progressive encephalopathy with only 10 patients(7.7%) formed the least common group. 42(31.3%) of the children suffered from Refractory status epilepticus. Also 40.3%(54 out of 134) of patients were neurologically abnormal before the episode of SE(P<0.01) and the older the child the more susceptile to have SE in an abnormal neurological background(P<0.001). Twenty five children(18.6%) died; 12 of them(50%) belonged to acute symptomatic group, 10(38.4%) remote symptomatic, 2(7.6%) idiopathic and only 1 patient(3.8%) died of febrile status epilepticus. Conclusion: Children under 2 years included more patients than the other age groups. The most common etiology was symptomatic group(acute & remote). Previous neurological abnormality was a significant factor in occurrence of SE. Acute symptomatic group was the most common etiology in the expired patients.