A study of clinical profile and outcome of children who presented with status epileptics in the PICU of a tertiary care hospital of central India

Abstract

Background: Status epileticus is an acute, life threatening neurological emergency that may lead to permanent neurological damage or even death. Status epileticus affects people of all ages, though it is more common and causes greater morbidity and mortality in infants and 1-5 yr age. Method: The Present study was conducted in the Department of Pediatrics tertiary care hospital. A total of 105 children were studied. All the children aged between 1 month - 14 year presenting with Status Epileticus , admitted in PICU in department of pediatrics. Data was collected after taking written consent, detailed history in a pretested proforma. Results: Total 105 subjects were included in final analysis out of which 55(52.4%) were male and 50(47.6%) female. Subjects had duration of seizure more than 30 minute at presentation . In our study showed that factors associated with a high risk of mortality in status epilepticus are GI hemorrhage (p value <0.001), significant mortality was observed in subjects who required MV on admission (p value < 0.0001 ) , hypotension (p-value 0.0003), prolonged duration of seizures (p- value 0.015), time taken to control seizures(p- value <0.0001), nutritional status (p value 0.008), infectious etiology(p value 0.0006).and distribution of subjects according to socioeconomic status and outcome also statically significant (p- value <0.0001), 100 % mortality was in super refractory group and 6(60%) mortality was seen in subjects who had not controlled seizure within 24 hour. Conclusion: In this study mortality was associated, risk factors being prolonged duration of seizures, infectious etiology, hypotension, Gastrointestinal hemorrhage and need for mechanical ventilation on admission. Prolong duration of seizures and not respond to AED were major contributing factors.