Comparison of pediatric patients with status epilepticus lasting 5-29min versus ≥30min

Iván Sánchez Fernández; Martina Vendrame; Kush Kapur; Jacqueline Klehm; Serife Uysal; Mustafa Gedik; Sookee An; Dinesh Jillella; Jacqueline Zelener; Sana Syed; Vasu Gooty; Alexander Rotenberg; Tobias Loddenkemper

doi:10.1016/j.yebeh.2014.05.018

Comparison of pediatric patients with status epilepticus lasting 5-29min versus ≥30min

Iván Sánchez Fernández, Martina Vendrame, Kush Kapur, Jacqueline Klehm, Serife Uysal, Mustafa Gedik, Sookee An, Dinesh Jillella, Jacqueline Zelener, Sana Syed, Vasu Gooty, Alexander Rotenberg, Tobias Loddenkemper

Pediatric Cardiology

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

The most common thresholds for considering prolonged seizures as status epilepticus (SE) are 5 and 30min. It is unknown whether these different thresholds (5 or 30min) identify patient populations with different electroclinical characteristics. We compared the characteristics of patients with SE lasting 5-29min (SE_5-29) with those with SE lasting ≥30min (SE_≥30). Inclusion criteria were the following: 1) 1month to 21years of age at the time of SE, 2) convulsive seizures, and 3) seizure duration ≥5min. Exclusion criteria were the following: 1) exclusively neonatal seizures, 2) psychogenic nonepileptic seizures, or 3) incomplete information about seizure duration. Four hundred forty-five patients (50.1% male) with a median (p₂₅-p₇₅) age at SE of 5.5 (2.8-10.5) years were enrolled. Status epilepticus lasted for 5-29min in 296 (66.5%) of subjects and for ≥30min in 149 (33.5%). Patients with SE_≥30 were younger than the patients with SE_5-29 at the time of seizure onset (median: 1 versus 2.1years, p=0.0007). Status epilepticus as the first seizure presentation was more frequent in patients with SE_≥30 (24.2% versus 12.2%, p=0.002). There was a tendency towards a higher rate of abnormalities in the magnetic resonance imaging at baseline in patients with SE_≥30 (70.5% versus 57.1%, p=0.061). Differences were not detected in seizure frequency, seizure types, presence of developmental delay, and electroencephalogram abnormalities at baseline. In the pediatric population, SE thresholds of either 5 or 30min identify groups of patients with very similar electroclinical characteristics, which may influence future definitions of pediatric SE.

Original language	English (US)
Pages (from-to)	1-6
Number of pages	6
Journal	Epilepsy and Behavior
Volume	37
DOIs	https://doi.org/10.1016/j.yebeh.2014.05.018
State	Published - Aug 2014

Bibliographical note

Funding Information:
Tobias Loddenkemper serves on the Laboratory Accreditation Board for Long-term (Epilepsy and ICU) Monitoring (ABRET), serves as a member of the American Clinical Neurophysiology Council (ACNS), serves on the American Board of Clinical Neurophysiology, serves as an Associate Editor of Seizure, performs video EEG long-term monitoring, EEGs, and other electrophysiological studies at Boston Children's Hospital and bills for these procedures, receives support from the HHV6 foundation NIH/ NINDS and PCORI by the Payer Provider Quality Initiative, receives funding from the American Epilepsy Society , the Epilepsy Foundation of America, the Epilepsy Therapy Project , the Pediatric Epilepsy Research Foundation , CURE , and the Danny Did Foundation , and received investigator initiated research support from Eisai Inc. and Lundbeck LLC .

Funding Information:
Iván Sánchez Fernández is funded by a grant for the study of epileptic encephalopathies from “ Fundacion Alfonso Martín Escudero ” and the HHV6 Foundation .

Funding Information:
This study was supported by a Career Development Fellowship Award from Harvard Medical School and Boston Children's Hospital (TL) and by a grant from the Program for Quality and Safety at Boston Children's Hospital (TL).

Keywords

EEG
Epidemiology
MRI
Pediatric
Status epilepticus

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10.1016/j.yebeh.2014.05.018

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title = "Comparison of pediatric patients with status epilepticus lasting 5-29min versus ≥30min",

abstract = "The most common thresholds for considering prolonged seizures as status epilepticus (SE) are 5 and 30min. It is unknown whether these different thresholds (5 or 30min) identify patient populations with different electroclinical characteristics. We compared the characteristics of patients with SE lasting 5-29min (SE5-29) with those with SE lasting ≥30min (SE≥30). Inclusion criteria were the following: 1) 1month to 21years of age at the time of SE, 2) convulsive seizures, and 3) seizure duration ≥5min. Exclusion criteria were the following: 1) exclusively neonatal seizures, 2) psychogenic nonepileptic seizures, or 3) incomplete information about seizure duration. Four hundred forty-five patients (50.1% male) with a median (p25-p75) age at SE of 5.5 (2.8-10.5) years were enrolled. Status epilepticus lasted for 5-29min in 296 (66.5%) of subjects and for ≥30min in 149 (33.5%). Patients with SE≥30 were younger than the patients with SE5-29 at the time of seizure onset (median: 1 versus 2.1years, p=0.0007). Status epilepticus as the first seizure presentation was more frequent in patients with SE≥30 (24.2% versus 12.2%, p=0.002). There was a tendency towards a higher rate of abnormalities in the magnetic resonance imaging at baseline in patients with SE≥30 (70.5% versus 57.1%, p=0.061). Differences were not detected in seizure frequency, seizure types, presence of developmental delay, and electroencephalogram abnormalities at baseline. In the pediatric population, SE thresholds of either 5 or 30min identify groups of patients with very similar electroclinical characteristics, which may influence future definitions of pediatric SE.",

keywords = "EEG, Epidemiology, MRI, Pediatric, Status epilepticus",

author = "{S{\'a}nchez Fern{\'a}ndez}, Iv{\'a}n and Martina Vendrame and Kush Kapur and Jacqueline Klehm and Serife Uysal and Mustafa Gedik and Sookee An and Dinesh Jillella and Jacqueline Zelener and Sana Syed and Vasu Gooty and Alexander Rotenberg and Tobias Loddenkemper",

note = "Funding Information: Tobias Loddenkemper serves on the Laboratory Accreditation Board for Long-term (Epilepsy and ICU) Monitoring (ABRET), serves as a member of the American Clinical Neurophysiology Council (ACNS), serves on the American Board of Clinical Neurophysiology, serves as an Associate Editor of Seizure, performs video EEG long-term monitoring, EEGs, and other electrophysiological studies at Boston Children's Hospital and bills for these procedures, receives support from the HHV6 foundation NIH/ NINDS and PCORI by the Payer Provider Quality Initiative, receives funding from the American Epilepsy Society , the Epilepsy Foundation of America, the Epilepsy Therapy Project , the Pediatric Epilepsy Research Foundation , CURE , and the Danny Did Foundation , and received investigator initiated research support from Eisai Inc. and Lundbeck LLC . Funding Information: Iv{\'a}n S{\'a}nchez Fern{\'a}ndez is funded by a grant for the study of epileptic encephalopathies from “ Fundacion Alfonso Mart{\'i}n Escudero ” and the HHV6 Foundation . Funding Information: This study was supported by a Career Development Fellowship Award from Harvard Medical School and Boston Children's Hospital (TL) and by a grant from the Program for Quality and Safety at Boston Children's Hospital (TL). ",

year = "2014",

month = aug,

doi = "10.1016/j.yebeh.2014.05.018",

language = "English (US)",

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journal = "Epilepsy and Behavior",

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T1 - Comparison of pediatric patients with status epilepticus lasting 5-29min versus ≥30min

AU - Sánchez Fernández, Iván

AU - Vendrame, Martina

AU - Kapur, Kush

AU - Klehm, Jacqueline

AU - Uysal, Serife

AU - Gedik, Mustafa

AU - An, Sookee

AU - Jillella, Dinesh

AU - Zelener, Jacqueline

AU - Syed, Sana

AU - Gooty, Vasu

AU - Rotenberg, Alexander

AU - Loddenkemper, Tobias

N1 - Funding Information: Tobias Loddenkemper serves on the Laboratory Accreditation Board for Long-term (Epilepsy and ICU) Monitoring (ABRET), serves as a member of the American Clinical Neurophysiology Council (ACNS), serves on the American Board of Clinical Neurophysiology, serves as an Associate Editor of Seizure, performs video EEG long-term monitoring, EEGs, and other electrophysiological studies at Boston Children's Hospital and bills for these procedures, receives support from the HHV6 foundation NIH/ NINDS and PCORI by the Payer Provider Quality Initiative, receives funding from the American Epilepsy Society , the Epilepsy Foundation of America, the Epilepsy Therapy Project , the Pediatric Epilepsy Research Foundation , CURE , and the Danny Did Foundation , and received investigator initiated research support from Eisai Inc. and Lundbeck LLC . Funding Information: Iván Sánchez Fernández is funded by a grant for the study of epileptic encephalopathies from “ Fundacion Alfonso Martín Escudero ” and the HHV6 Foundation . Funding Information: This study was supported by a Career Development Fellowship Award from Harvard Medical School and Boston Children's Hospital (TL) and by a grant from the Program for Quality and Safety at Boston Children's Hospital (TL).

PY - 2014/8

Y1 - 2014/8

N2 - The most common thresholds for considering prolonged seizures as status epilepticus (SE) are 5 and 30min. It is unknown whether these different thresholds (5 or 30min) identify patient populations with different electroclinical characteristics. We compared the characteristics of patients with SE lasting 5-29min (SE5-29) with those with SE lasting ≥30min (SE≥30). Inclusion criteria were the following: 1) 1month to 21years of age at the time of SE, 2) convulsive seizures, and 3) seizure duration ≥5min. Exclusion criteria were the following: 1) exclusively neonatal seizures, 2) psychogenic nonepileptic seizures, or 3) incomplete information about seizure duration. Four hundred forty-five patients (50.1% male) with a median (p25-p75) age at SE of 5.5 (2.8-10.5) years were enrolled. Status epilepticus lasted for 5-29min in 296 (66.5%) of subjects and for ≥30min in 149 (33.5%). Patients with SE≥30 were younger than the patients with SE5-29 at the time of seizure onset (median: 1 versus 2.1years, p=0.0007). Status epilepticus as the first seizure presentation was more frequent in patients with SE≥30 (24.2% versus 12.2%, p=0.002). There was a tendency towards a higher rate of abnormalities in the magnetic resonance imaging at baseline in patients with SE≥30 (70.5% versus 57.1%, p=0.061). Differences were not detected in seizure frequency, seizure types, presence of developmental delay, and electroencephalogram abnormalities at baseline. In the pediatric population, SE thresholds of either 5 or 30min identify groups of patients with very similar electroclinical characteristics, which may influence future definitions of pediatric SE.

AB - The most common thresholds for considering prolonged seizures as status epilepticus (SE) are 5 and 30min. It is unknown whether these different thresholds (5 or 30min) identify patient populations with different electroclinical characteristics. We compared the characteristics of patients with SE lasting 5-29min (SE5-29) with those with SE lasting ≥30min (SE≥30). Inclusion criteria were the following: 1) 1month to 21years of age at the time of SE, 2) convulsive seizures, and 3) seizure duration ≥5min. Exclusion criteria were the following: 1) exclusively neonatal seizures, 2) psychogenic nonepileptic seizures, or 3) incomplete information about seizure duration. Four hundred forty-five patients (50.1% male) with a median (p25-p75) age at SE of 5.5 (2.8-10.5) years were enrolled. Status epilepticus lasted for 5-29min in 296 (66.5%) of subjects and for ≥30min in 149 (33.5%). Patients with SE≥30 were younger than the patients with SE5-29 at the time of seizure onset (median: 1 versus 2.1years, p=0.0007). Status epilepticus as the first seizure presentation was more frequent in patients with SE≥30 (24.2% versus 12.2%, p=0.002). There was a tendency towards a higher rate of abnormalities in the magnetic resonance imaging at baseline in patients with SE≥30 (70.5% versus 57.1%, p=0.061). Differences were not detected in seizure frequency, seizure types, presence of developmental delay, and electroencephalogram abnormalities at baseline. In the pediatric population, SE thresholds of either 5 or 30min identify groups of patients with very similar electroclinical characteristics, which may influence future definitions of pediatric SE.

KW - EEG

KW - Epidemiology

KW - MRI

KW - Pediatric

KW - Status epilepticus

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JO - Epilepsy and Behavior

JF - Epilepsy and Behavior

ER -

Comparison of pediatric patients with status epilepticus lasting 5-29min versus ≥30min

Abstract

Bibliographical note

Keywords

Publisher link

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