ArticlesIncidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study
Introduction
Convulsive status epilepticus is the most common medical neurological emergency in childhood.1, 2 Despite treatment advances over the last two decades, it continues to be associated with substantial morbidity and mortality.3, 4, 5, 6 However, since most of the published data for convulsive status epilepticus in childhood are from hospital-based studies, the size of the population at risk, the range of causes, and the natural history in the general population of children have not been well defined.
Previously reported epidemiological studies of convulsive status epilepticus have been mainly or entirely based on adult populations and thus their results might not provide a reliable characterisation of this disorder in children.2, 7, 8, 9, 10, 11, 12 Furthermore, data from adults might not be directly applicable to children because the physical and neurochemical characteristics of the developed brain differ from those of the developing brain.13 Thus we undertook the North London Convulsive Status Epilepticus in Childhood Surveillance Study (NLSTEPSS), a prospective population-based study, to investigate these issues in an urban resource-rich setting.
Section snippets
Definitions
We defined convulsive status epilepticus as a tonic, clonic, or tonic-clonic seizure (continuous convulsive status epilepticus), or two or more such seizures between which consciousness was not regained (intermittent convulsive status epilepticus), which lasted for at least 30 min.14
Children with no previous convulsive status epilepticus before enrolment into the study were defined as having “first ever episodes” of convulsive status epilepticus. All episodes of convulsive status epilepticus
Results
226 children were enrolled into NLSTEPSS, of whom 176 had first ever episodes of convulsive status epilepticus and 50 had had at least one previous episode. There was no difference in ascertainment between years nor was there any seasonal variation in incidence. However, in the first year, 99 (69%) of children enrolled into NLSTEPSS had first ever convulsive status epilepticus but in the second year 77 (93%) of those enrolled had first ever convulsive status epilepticus. Of the children with a
Discussion
Our results show that the frequency, range of causes, and mortality of convulsive status epilepticus in childhood differ from published population-based data for this disorder in adults. In view of the large size of the study cohort and the high ascertainment (74–81%), our study is likely to provide a comprehensive and reliable characterisation of the epidemiology of childhood convulsive status epilepticus.
The incidence of convulsive status epilepticus in childhood in north London is 18–20 per
References (30)
Presentation, evaluation, and treatment of nonconvulsive status epilepticus
Epilepsy Behav
(2000)- et al.
Analysis of clinical characteristics and risk factors for mortality in human status epilepticus
Seizure
(2003) Status epilepticus
Clin Ther
(1985)- et al.
Epidemiology of status epilepticus
J Clin Neurophysiol
(1995) - et al.
Status epilepticus in children
Can J Neurol Sci
(1988) - et al.
Short-term mortality after a first episode of status epilepticus
Epilepsia
(1997) - et al.
Morbidity of nonfebrile status epilepticus in Rochester, Minnesota, 1965–1984
Epilepsia
(1998) - et al.
Long-term mortality after a first episode of status epilepticus
Neurology
(2002) - et al.
Incidence of status epilepticus in Rochester, Minnesota, 1965–1984
Neurology
(1998) - et al.
Incidence of status epilepticus in French-speaking Switzerland: (EPISTAR)
Neurology
(2000)
Incidence of status epilepticus in adults in Germany: a prospective, population-based study
Epilepsia
Incidence and mortality of generalized convulsive status epilepticus in California
Neurology
The impact of convulsive status epilepticus on the risk of death varies by age
Epilepsia
A systematic review of the epidemiology of status epilepticus
Eur J Neurol
Epilepsy in the developing brain: lessons from the laboratory and clinic
Epilepsia
Cited by (457)
Prophylactic antiseizure medications for recurrent status epilepticus in nonsyndromic childhood epilepsy
2024, Brain and DevelopmentTherapeutic hypothermia and its role in the neuroprotection of the pediatric critical patient
2023, Acta Colombiana de Cuidado Intensivo
- ‡
Members listed at end of paper