Background and Aims Children presenting with CSE are commonly referred to PICU for ongoing care. Limited data is available on their outcome.

Objectives

1. To determine mortality and short-term morbidity of children admitted to a regional PICU with CSE.

2. 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.