The Prognostic Factors in Children With Status Epilepticus and Status Epilepticus Severity Score Scales

Abstract

Background: According to the International League Against Epilepsy (ILAE) 2015 classification, status epilepticus (SE) is a seizure that lasts longer than 5 min or a frequency of more than one seizure within 5 min, without returning to a normal level of consciousness between episodes. In this study, we aimed to evaluate the prognostic factors of SE and compare our patients with those of patients treated internationally with the modified status epilepticus severity score (mSTESS) to determine the reliability of this scoring system. Methods: The medical records of patients aged 1 month-17 years with SE who were treated at Çukurova University-Balcalı Training and Research Hospital between September 2018 and September 2021 and who were followed in the intensive care unit were included in the study. Results: Seventy-two patients were included in this study. The mean age of the patients with SE was 5 years (3-8). The male/female ratio was 34 (47%)/38 (53%). A history of epilepsy was present in 53% of the patients. The most common etiologies behind SE were meningoencephalitis (19%), febrile status (8%), unknown status (12%), and genetic causes (7%). Comorbidities, including developmental delay/intellectual disability, cerebral palsy, hyperactivity, and autism spectrum disorder, were present in 44 (61%) of the patients. The cutoff was ≥ 2 for unfavorable outcomes and 4 for mortality in our patients according to the mSTESS system. The case mortality rate was 1% in our study. Nonconvulsive SE, slowing and abnormal ground on EEG, being stuporous or comatose, having abnormal MRI-CT, and having a comorbid condition were associated with an unfavorable prognosis in SE patients. Conclusion: The mSTESS is a useful and practical scoring system for predicting the prognosis of SE patients. Nonconvulsive SE, slowing and abnormal ground in EEG, being stuporous or comatose, abnormal MRI-CT, and the presence of comorbid conditions indicated poor prognosis of SE in children.

Keywords: mSTESS; prognosis; status epilepticus.