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Neuropediatrics 2005; 36(3): 186-192
DOI: 10.1055/s-2005-865611
Original Article

Georg Thieme Verlag KG Stuttgart · New York

Risk Factors for Fatality and Neurological Sequelae after Status Epilepticus in Children

Y. Maegaki1 , Y. Kurozawa2 , K. Hanaki3 , K. Ohno1
  • 1Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan
  • 2Division of Health Administration and Promotion, Faculty of Medicine, Tottori University, Yonago, Japan
  • 3Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Japan
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Publication History

Received: October 27, 2004

Accepted after Revision: March 25, 2005

Publication Date:
09 June 2005 (online)

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Abstract

Using multivariate regression analysis, we examined risk factors for fatality and neurological sequelae after status epilepticus (SE) in children. Possible risk factors included sex, age at onset, the cause of SE, pyrexia, asthmatic attack during SE, past history of seizure, predisposing neurological abnormality, seizure duration, type of seizure, and medication with theophylline. Consecutive patients with SE, aged 1 month to 18 years, who were referred to Tottori University Hospital from 1984 to 2002 were reviewed. Of the 234 patients enrolled, 45 patients (19.2 %) showed poor outcomes, namely early death in 9 and neurological sequela in 36. Acute neurological insult and progressive neurological disease as the cause of SE were very significantly related to poor outcome (OR = 33.68, p = 0.000). We excluded 21 patients with the etiology of acute neurological insult and progressive neurological disease and then reanalyzed risk factors in the remaining 213 patients. Twenty-nine patients (13.6 %) showed poor outcome, namely early death in 6 and neurological sequela in 23. Seizure duration of more than 2 hours (OR = 12.73, p = 0.000) and moderate to severe asthmatic attack (OR = 31.61, p = 0.010) were associated with poor outcome. These results indicate that long-lasting seizure activity and asthmatic attack can exacerbate SE-associated brain injury.

Key words

Status epilepticus - risk factor - prognosis - children

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M.D. Yoshihiro Maegaki

Division of Child Neurology
Institute of Neurological Sciences
Faculty of Medicine
Tottori University

36-1 Nishi-machi

Yonago 683-8504

Japan

Email: maegaki@grape.med.tottori-u.ac.jp