Clinico-laboratory profile and immediate outcome of paediatric status epilepticus in a tertiary care hospital in South India

Abstract

Convulsive status epilepticus is one of the common causes of children getting hospitalized to paediatric intensive care units and is associated with high morbidity and mortality. The objective of the study is to analyse the clinical presentation, laboratory parameters and immediate outcome of children admitted with status epilepticus to the PICU. A prospective study was performed at Saveetha Medical College Hospital, January 2016 to December 2016. Detailed history and examination of children followed by relevant investigations including biochemical parameters were done during hospitalization with the immediate outcome. During the study period, 54 children admitted with status epilepticus between the age group of 10 months to 15 years. Out of the 54 children, 22 children (40.7 %) were admitted with status epilepticus without any prior history of seizures, while 32 children (59.3%) had a previous history of seizures and 20 children (37%) presented with febrile status epilepticus. Seizure duration between 30-60 minutes was seen in 29 (53.7 %) patients whereas 7 children (12.2%) presented with refractory status epilepticus. Low haemoglobin (<10 gm/dl) was observed in 15 children (27.7 %), hypocalcemia in 6 children (11.1%) and hyponatremia (<135mg/dl) was observed in 18 children (33.3%). 8 children (15.7%) had abnormal neuroimaging. The mortality was 5.5 % and all children who died had refractory status epilepticus. Younger children below 5 years had a higher incidence of status epilepticus. The commonest type of seizure was a generalized tonic-clonic seizure. Mortality was observed more in refractory status epilepticus.