Clinical and EEG features of various types of status epilepticus in childhood

Abstract

Objectives: To analyse the clinical and EEG features of various types of status epilepticus (SE) in childhood in order to recognize and manage SE in the early stage. Methods: The types of SE confirmed by video-EEG in 27 children were classified basing on seizure types. The effects of ages, etiology, brain developmental levels, provoked factors and responses to antiepileptic drugs (AED) on SE were analysed. Results: This group included most types of SE. There were 18 patients with symptomatic epilepsy, 9 with history of SE, and 2 with recent SE as the first epileptic seizure. Seventeen children had neurodevelopmental delayed occurrence prior to SE. The seizure frequency was more than 10 times a day in 22 children. Potential causes of SE were with drawing AED in 8 cases, acute non-central nervous system infection in 6 cases and hypocalcemia in one case. The onset of epilepsy and SE were significantly earlier in children with symptomatic epilepsy than those with cryptogenic or idiopathic epilepsy (P < 0.05). The clinical and EEG features were different depending on various etiologies in spite of having the same SE type. Intra venous injection of clonizepame was efficient to control SE in 11 of the 13 patients. Conclusions: The clinical and EEG features of SE were closely related to the ages of SE, the brain developmental levels, the etiology and epileptic syndromes. Most of SE had fluctuated clinical symptoms and EEG patterns. The high risk factors suggested developing SE included symptomatic epilepsy, neurodevelopment delay, markedly increased seizure frequency, suddenly changing or withdrawing of AED, complicating infection and metabolic disturbance. Intra venous injection of clonizepame had rapid and obvious effect on inhibiting abnormal discharges and improving clinical symptoms, and may help to diagnose nonconvulsive SE.