Background and Aims Children presenting with CSE are commonly referred to PICU for ongoing care. Limited data is available on their outcome.
To determine mortality and short-term morbidity of children admitted to a regional PICU with CSE.
To identify differences in outcome for those with pre-existing epilepsy compared to non-epileptics.
Methods A retrospective cohort study of 57 children (1 month to 16 years) admitted to a regional PICU between January 2008 and December 2011 with CSE was carried out. Study population were divided into Group 1 (n=23, presence of pre-existing epilepsy) and Group 2 (n=34, absence of pre-existing epilepsy).
Results The results of the group 1 and 2 respectively were:
Median age (months): 33 and 21.5
Male: female ratio (%): 57:43 and 76:24
Refractory seizures (>60 min) at presentation: 83% and 53%
Deviation from APLS protocol for seizure control: 43% and 32%
Extra doses of benzodiazepine: 50% and 91%
Neurological co-morbidity:91% and 24%
Median duration of PICU ventilation:18.1 hrs and 10.5 hrs
Median duration of PICU stay:24.1 and 24.5 hrs
Seizure control at PICU admission: 61% and 94%
Midazolam infusion in PICU: 96% and 97%
Neurological investigations (LP, CT/MRI Head, EEG) performed in 22% and 94%
Pre-discharge neurological morbidity: 2 (aggressive behaviour, decerebrate posturing) and 1 (increased tone)
No mortality identified
Conclusion Epileptics presented frequently with refractory seizures and were ventilated longer though this didn’t affect total PICU stay; non-epileptics were investigated more frequently. Morbidity (5%) was still seen though there was no mortality in our study.
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