Childhood convulsive status epilepticus: epidemiology, management and outcome

Authors: Neville, B. G. R.; Chin, R. F. M.; Scott, R. C.

Source: Acta Neurologica Scandinavica, Volume 115, Supplement 186, April 2007 , pp. 21-24(4)

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Abstract:

Neville BGR, Chin RFM, Scott RC. Childhood convulsive status epilepticus: epidemiology, management and outcome.

Convulsive status epilepticus (CSE) in childhood is a medical emergency and its aetiology and outcome mean that it should be studied separately from adult CSE. The incidence in developed countries is between 17 and 23/100,000 with a higher incidence in younger children. Febrile CSE is the commonest single group with a good prognosis in sharp distinction to CSE related to central nervous system infections which have a high mortality. The aim of treatment is to intervene at 5 min and studies indicate that intravenous (i.v.) lorazepam may be a better first-line treatment than rectal diazepam and i.v. phenytoin a better second-line treatment than rectal paraldehyde. An epidemiological study strongly supports the development of prehospital treatment with buccal midazolam becoming a widely used but unlicensed option in the community. More than two doses of benzodiazepines increase the rate of respiratory depression without obvious benefit. The 1 year recurrence rate is 17% and the hospital mortality is about 3%.

Keywords: convulsive status epilepticus; childhood; epidemiology; management

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1600-0404.2007.00805.x

Publication date: 2007-04-01