PMID- 29587188 OWN - NLM STAT- MEDLINE DCOM- 20190221 LR - 20190221 IS - 1525-5069 (Electronic) IS - 1525-5050 (Linking) VI - 82 DP - 2018 May TI - Nonconvulsive status epilepticus after cessation of convulsive status epilepticus in pediatric intensive care unit patients. PG - 68-73 LID - S1525-5050(17)31018-1 [pii] LID - 10.1016/j.yebeh.2018.02.008 [doi] AB - Little is known about pediatric patients suffering from nonconvulsive status epilepticus (NCSE) after convulsive status epilepticus (CSE) cessation. The aim of this study was to identify in pediatric patients the clinical characteristics of NCSE after CSE cessation and the factors that contribute to patient outcomes. Data from clinical features, electroencephalography (EEG) characteristics, neuroimaging findings, treatments, and prognosis were systematically summarized, and the associations between clinical characteristics and prognosis were quantified. Thirty-eight children aged 51days-14years, 2months were identified in the Chongqing Medical University pediatric intensive care unit as having experienced NCSE after CSE cessation between October 1, 2014 and April 1, 2017. All patients were comatose, 15 of whom presented subtle motor signs. The most common underlying etiology was acute central nervous system (CNS) infection. Electroencephalography (EEG) data showed that, during the NCSE period, all patients had several discrete episodes (lasting from 30s to 6h long), and the most common duration was 1-5min. The ictal onset locations were classified as focal (16 patients, 42.1%), multiregional independent (10 patients, 26.3%), and generalized (12 patients, 31.6%). Wave morphologies varied during the ictal and interictal periods. Neuroimaging detected signal abnormalities in the cerebral cortex or subcortex of 33 patients with NCSE (87%), which were classified as either multifocal and consistent with extensive cortical edema (21 patients, 55.3%) or focal (12 patients, 31.6%). Twelve patients were on continuous intravenous phenobarbital, and 31 were on continuous infusion of either midazolam (27 patients) or propofol (4 patients). At least one other antiepileptic drug was prescribed for 32 patients. Three patients were on mild hypothermia therapy. The duration of NCSE lasted <24h for 20 patients and >24h for 18 patients. The mortality rate was 21.1%, and half of the surviving patients had severe neurological morbidity. Our results indicated that EEG monitoring after treatment of CSE was essential to the recognition of persistent seizures. The clinical features, EEG characteristics, and neuroimaging findings varied during the NCSE period. The morbidity is high in pediatric patients who had NCSE after CSE. Convulsive status epilepticus (CSE) duration and neuroimaging results may be related to the prognosis. CI - Copyright (c) 2018 Elsevier Inc. All rights reserved. FAU - Chen, Jin AU - Chen J AD - Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Xie, Lingling AU - Xie L AD - Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Hu, Yue AU - Hu Y AD - Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Lan, Xinghui AU - Lan X AD - Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. FAU - Jiang, Li AU - Jiang L AD - Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China. Electronic address: dr_jiangli@hotmail.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180326 PL - United States TA - Epilepsy Behav JT - Epilepsy & behavior : E&B JID - 100892858 RN - R60L0SM5BC (Midazolam) RN - YI7VU623SF (Propofol) RN - YQE403BP4D (Phenobarbital) SB - IM MH - Administration, Intravenous MH - Adolescent MH - Cerebral Cortex/diagnostic imaging/physiopathology MH - Child MH - Child, Preschool MH - Electroencephalography/drug effects/*trends MH - Female MH - Follow-Up Studies MH - Humans MH - Infant MH - Intensive Care Units, Pediatric/*trends MH - Male MH - Midazolam/administration & dosage MH - Phenobarbital/administration & dosage MH - Propofol/administration & dosage MH - Retrospective Studies MH - Status Epilepticus/*diagnostic imaging/drug therapy/*physiopathology OTO - NOTNLM OT - Convulsive status epilepticus OT - ICU OT - Nonconvulsive status epilepticus OT - Pediatric patients EDAT- 2018/03/28 06:00 MHDA- 2019/02/23 06:00 CRDT- 2018/03/28 06:00 PHST- 2017/12/13 00:00 [received] PHST- 2018/01/25 00:00 [revised] PHST- 2018/02/09 00:00 [accepted] PHST- 2018/03/28 06:00 [pubmed] PHST- 2019/02/23 06:00 [medline] PHST- 2018/03/28 06:00 [entrez] AID - S1525-5050(17)31018-1 [pii] AID - 10.1016/j.yebeh.2018.02.008 [doi] PST - ppublish SO - Epilepsy Behav. 2018 May;82:68-73. doi: 10.1016/j.yebeh.2018.02.008. Epub 2018 Mar 26.