OBJECTIVE: A high prevalence of nonconvulsive status epilepticus (NCSE) has been reported in critically ill adults and neonates. Recent prospective pediatric studies focus on critically ill children and show wide variability in the frequency of NCSE. This study examines prevalence of pediatric NCSE regardless of inpatient setting and retrospectively identifies risk factors indicating a need for urgent continuous EEG. METHODS: Medical records from patients aged 3 months to 21 years were identified either by (1) searching a clinical EEG database (n = 18) or (2) consecutive inpatient EEG referrals for NCSE over an 8-month period (n = 57). RESULTS: Seventy-five children, mean age of 7.8 years, were studied. NCSE was identified in 26 patients (35%) and in 8 of 57 (14%) patients referred for possible NCSE. More than half of the patients referred were outside of the ICU. A witnessed clinical seizure was observed in 24 of 26 (92%) patients with NCSE. Acute cortical neuroimaging abnormalities were significantly more frequent in patients with NCSE. The presence of clinical seizures and acute neuroimaging abnormality was associated with an 82% probability of NCSE. All but 1 patient with NCSE had electrographic or electroclinical seizures within the first hour of monitoring. CONCLUSIONS: A high prevalence of NCSE was observed, comparable to adult studies, but within a wider range of inpatient settings. Children with acute encephalopathy should undergo continuous EEG. This evaluation is more urgent if certain clinical risk factors are present. Optimal duration of monitoring and the effect of NCSE on prognosis should be studied.
OBJECTIVE: A high prevalence of nonconvulsive status epilepticus (NCSE) has been reported in critically ill adults and neonates. Recent prospective pediatric studies focus on critically ill children and show wide variability in the frequency of NCSE. This study examines prevalence of pediatric NCSE regardless of inpatient setting and retrospectively identifies risk factors indicating a need for urgent continuous EEG. METHODS: Medical records from patients aged 3 months to 21 years were identified either by (1) searching a clinical EEG database (n = 18) or (2) consecutive inpatient EEG referrals for NCSE over an 8-month period (n = 57). RESULTS: Seventy-five children, mean age of 7.8 years, were studied. NCSE was identified in 26 patients (35%) and in 8 of 57 (14%) patients referred for possible NCSE. More than half of the patients referred were outside of the ICU. A witnessed clinical seizure was observed in 24 of 26 (92%) patients with NCSE. Acute cortical neuroimaging abnormalities were significantly more frequent in patients with NCSE. The presence of clinical seizures and acute neuroimaging abnormality was associated with an 82% probability of NCSE. All but 1 patient with NCSE had electrographic or electroclinical seizures within the first hour of monitoring. CONCLUSIONS: A high prevalence of NCSE was observed, comparable to adult studies, but within a wider range of inpatient settings. Children with acute encephalopathy should undergo continuous EEG. This evaluation is more urgent if certain clinical risk factors are present. Optimal duration of monitoring and the effect of NCSE on prognosis should be studied.
Authors: Nicholas S Abend; Katherine L Wagenman; Taylor P Blake; Maria T Schultheis; Jerilynn Radcliffe; Robert A Berg; Alexis A Topjian; Dennis J Dlugos Journal: Epilepsy Behav Date: 2015-04-20 Impact factor: 2.937
Authors: Susan T Herman; Nicholas S Abend; Thomas P Bleck; Kevin E Chapman; Frank W Drislane; Ronald G Emerson; Elizabeth E Gerard; Cecil D Hahn; Aatif M Husain; Peter W Kaplan; Suzette M LaRoche; Marc R Nuwer; Mark Quigg; James J Riviello; Sarah E Schmitt; Liberty A Simmons; Tammy N Tsuchida; Lawrence J Hirsch Journal: J Clin Neurophysiol Date: 2015-04 Impact factor: 2.177
Authors: Katherine L Wagenman; Taylor P Blake; Sarah M Sanchez; Maria T Schultheis; Jerilynn Radcliffe; Robert A Berg; Dennis J Dlugos; Alexis A Topjian; Nicholas S Abend Journal: Neurology Date: 2014-01-02 Impact factor: 9.910
Authors: Nicholas S Abend; Kevin E Chapman; William B Gallentine; Joshua Goldstein; Ann E Hyslop; Tobias Loddenkemper; Kendall B Nash; James J Riviello; Cecil D Hahn Journal: Curr Neurol Neurosci Rep Date: 2013-03 Impact factor: 5.081
Authors: Lila T Worden; Dhinakaran M Chinappen; Sally M Stoyell; Jacquelyn Gold; Luis Paixao; Kalpathy Krishnamoorthy; Mark A Kramer; Michael B Westover; Catherine J Chu Journal: Epilepsia Date: 2019-11-19 Impact factor: 5.864