Purpose To determine the aetiology and clinical features of seizures in critically ill children admitted to paediatric intensive care unit (PICU).
Methods A total of 203 children were admitted from June to November 2013, 45 patients were eligible. Age ranged from 2 months to 19 years. Seizures were organised as epileptic or non-epileptic. Demographic data, PRISM III, GCS, risk factors, coexistent diagnosis, medications administered before admission, type and duration of seizures, drugs used, requirement and duration of mechanical ventilation, length of stay and neuroimaging findings were collected prospectively.
Results The male-female ratio was 0.8. Mean age was 5.4. The most common causes of seizures were non-epileptic. Most frequent coexistent diagnosis was infectious diseases and 53.3% had recurrent seizures. Medications were administered to 51.1% of the patients before admission. Seizures were focal in 21 (46.7%), generalised in 11 (24.4%) and 13 (28.9%) had status epilepticus. Intravenous midazolam was first line therapy in 48.9%. Non-epileptic seizures were usually new onset and duration was shorter. Epileptic seizures tended to be recurrent and likely to progress to status epilepticus. However, type of seizures didn’t change severity of the disease. Also, laboratory test results, medications administered before admission, requirement and duration of ventilation, mortality and length of stay was not significant between epileptic/non-epileptic patients.
Conclusion Seizures in critically ill children that may evolve into status epilepticus is an important condition requiring attention regardless of cause. Intensified educational programs for PICU physicians and international guidelines are necessary for a more efficient approach to children with seizures.