Admissions to a pediatric intensive care unit for status epilepticus: a 10-year experience

Crit Care Med. 1994 May;22(5):827-32. doi: 10.1097/00003246-199405000-00019.


Objective: To characterize the etiology, course, and prognosis in children admitted to a pediatric intensive care unit (ICU) for status epilepticus.

Design: Retrospective, descriptive study.

Setting: Pediatric ICU in a university hospital.

Patients: One hundred forty-seven children admitted with status epilepticus.

Interventions: None.

Measurements and main results: Status epilepticus was defined as a prolonged (> 30 mins) or repeated tonic or tonic-clonic seizure with a persistent altered state of consciousness. Over 10 yrs, 147 children 0 to 16 yrs of age (median 1; mean 3.4 +/- 3.9 [SD]) were admitted to a pediatric ICU for, or with, 153 episodes of status epilepticus. Status epilepticus was caused most often by epilepsy (n = 52), atypical febrile convulsions (n = 21), bacterial meningitis (n = 20), encephalitis (n = 20), intoxication (n = 8), or a metabolic disorder (n = 12). Two infants, 1 and 3 months of age, and a patient with intoxication by isoniazid, responded to pyridoxine. Among 114 previously normal children, 34 patients displayed a new neurologic problem on discharge from the ICU, among whom, 68% (23/34) still had some neurologic abnormality 1 yr after the episode of status epilepticus. Nine patients died during their ICU stay, mostly from underlying disease rather than from the status epilepticus itself. A normal neurologic status before status epilepticus and age < 4 yrs seem to be markers of good prognosis, while encephalitis and meningitis appear to be markers for morbidity and mortality.

Conclusions: Most cases of status epilepticus were caused by epilepsy, atypical febrile seizure, encephalitis, meningitis, or metabolic disease. The mortality rate during the ICU stay was 6%. The prognosis was good in most surviving cases, more so if the neurologic development of the child was normal before the status epilepticus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Hospital Mortality
  • Hospitals, University / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Pediatric / statistics & numerical data*
  • Neurologic Examination
  • Outcome Assessment, Health Care
  • Patient Admission / statistics & numerical data*
  • Patient Admission / trends
  • Prognosis
  • Quebec / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Status Epilepticus / classification
  • Status Epilepticus / diagnosis
  • Status Epilepticus / epidemiology*
  • Status Epilepticus / etiology
  • Status Epilepticus / therapy
  • Survival Rate