Retrospective review of pediatric status epilepticus in 116 Saudi patients: predictors of outcome

Ann Saudi Med. 2017 Nov-Dec;37(6):455-460. doi: 10.5144/0256-4947.2017.455.

Abstract

Background: Status epilepticus (SE) is a common, life-threatening condition. Multiple factors are used to predict its outcome and evaluate its risks, and there have been only a few studies in Saudi Arabia.

Objectives: Investigate predictors of SE outcome.

Design: Retrospective chart review study.

Setting: Tertiary center, Riyadh.

Patients and methods: We reviewed all pediatric cases (age 14 years or younger) of SE admitted between January 2005 and December 2015, collecting data on age, sex, date of birth, developmental status, pre-existing neurological diseases, SE etiology, Glasgow Outcome Scale (GOS) scores, and electroencephalogram (EEG) findings. The outcome was categorized as poor based on any decrease in baseline GOS score or moderate-to-severe developmental delay in young children; otherwise outcome was considered good.

Main outcome measure: Outcome of SE.

Results: One hundred and sixteen patients (54% boys) with ages from 1 month to 10 years were included in the analysis. Fifty-five (47.4%) had a poor outcome. The overall mortality rate related to SE was 2.6%. Four patients had an SE duration of more than 24 hours. Univariate and multivariate analysis revealed that poor outcome was related to symptomatic SE etiology and a history of epilepsy. Age, sex, SE duration, and EEG findings were not predictors of poor outcome.

Conclusion: Pediatric status epilepticus is highly associated with neurological morbidity. The main pre.dictor of outcome is underlying symptomatic etiology of SE and to a lesser degree the presence of a history of epilepsy. Duration does not seem to play a major role.

Limitations: The main limitation is the retrospective chart review nature of the study with possible bias.

MeSH terms

  • Child
  • Child, Preschool
  • Developmental Disabilities / epidemiology*
  • Electroencephalography
  • Epilepsy / epidemiology*
  • Female
  • Glasgow Outcome Scale
  • Humans
  • Infant
  • Male
  • Multivariate Analysis
  • Retrospective Studies
  • Saudi Arabia / epidemiology
  • Status Epilepticus / epidemiology*
  • Status Epilepticus / mortality
  • Status Epilepticus / physiopathology
  • Tertiary Care Centers
  • Time Factors