Iván Sánchez Fernández1, Michele C Jackson1, Nicholas S Abend1, Ravindra Arya1, James N Brenton1, Jessica L Carpenter1, Kevin E Chapman1, William D Gaillard1, Marina Gaínza-Lein1, Tracy A Glauser1, Joshua L Goldstein1, Howard P Goodkin1, Ashley Helseth1, Kush Kapur1, Tiffani L McDonough1, Mohamad A Mikati1, Katrina Peariso1, James Riviello1, Robert C Tasker1, Alexis A Topjian1, Mark S Wainwright1, Angus Wilfong1, Korwyn Williams1, Tobias Loddenkemper2. 1. From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.C.J., M.G.L., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Division of Neurology (N.S.A., A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania; Cincinnati Children's Hospital Medical Center (R.A., T.A.G., K.P.), University of Cincinnati, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), The University of Virginia Health System, Charlottesville; Department of Epilepsy, Neurophysiology, and Critical Care Neurology (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Universidad Austral de Chile (M.G.L.), Valdivia, Chile; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.H., M.A.M.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M., J.R.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Section of Neurology and Developmental Neuroscience (A.W.), Department of Pediatrics, Baylor College of Medicine, Houston, TX; Barrows Neurological Institute (K.W.), Phoenix Children's Hospital; Department of Pediatrics (K.W.), University of Arizona School of Medicine, Tucson; and Department of Neurology (K.W.), Mayo Clinic, Scottsdale, AZ. 2. From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.C.J., M.G.L., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Division of Neurology (N.S.A., A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania; Cincinnati Children's Hospital Medical Center (R.A., T.A.G., K.P.), University of Cincinnati, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), The University of Virginia Health System, Charlottesville; Department of Epilepsy, Neurophysiology, and Critical Care Neurology (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Universidad Austral de Chile (M.G.L.), Valdivia, Chile; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.H., M.A.M.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M., J.R.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Section of Neurology and Developmental Neuroscience (A.W.), Department of Pediatrics, Baylor College of Medicine, Houston, TX; Barrows Neurological Institute (K.W.), Phoenix Children's Hospital; Department of Pediatrics (K.W.), University of Arizona School of Medicine, Tucson; and Department of Neurology (K.W.), Mayo Clinic, Scottsdale, AZ. tobias.loddenkemper@childrens.harvard.edu.
Abstract
OBJECTIVE: To compare refractory convulsive status epilepticus (rSE) management and outcome in children with and without a prior diagnosis of epilepsy and with and without a history of status epilepticus (SE). METHODS: This was a prospective observational descriptive study performed from June 2011 to May 2016 on pediatric patients (1 month-21 years of age) with rSE. RESULTS: We enrolled 189 participants (53% male) with a median (25th-75th percentile) age of 4.2 (1.3-9.6) years. Eighty-nine (47%) patients had a prior diagnosis of epilepsy. Thirty-four (18%) patients had a history of SE. The time to the first benzodiazepine was similar in participants with and without a diagnosis of epilepsy (15 [5-60] vs 16.5 [5-42.75] minutes, p = 0.858). Patients with a diagnosis of epilepsy received their first non-benzodiazepine (BZD) antiepileptic drug (AED) later (93 [46-190] vs 50.5 [28-116] minutes, p = 0.002) and were less likely to receive at least one continuous infusion (35/89 [39.3%] vs 57/100 [57%], p = 0.03). Compared to patients with no history of SE, patients with a history of SE received their first BZD earlier (8 [3.5-22.3] vs 20 [5-60] minutes, p = 0.0073), although they had a similar time to first non-BZD AED (76.5 [45.3-124] vs 65 [32.5-156] minutes, p = 0.749). Differences were mostly driven by the patients with an out-of-hospital rSE onset. CONCLUSIONS: Our study establishes that children with rSE do not receive more timely treatment if they have a prior diagnosis of epilepsy; however, a history of SE is associated with more timely administration of abortive medication.
OBJECTIVE: To compare refractory convulsive status epilepticus (rSE) management and outcome in children with and without a prior diagnosis of epilepsy and with and without a history of status epilepticus (SE). METHODS: This was a prospective observational descriptive study performed from June 2011 to May 2016 on pediatric patients (1 month-21 years of age) with rSE. RESULTS: We enrolled 189 participants (53% male) with a median (25th-75th percentile) age of 4.2 (1.3-9.6) years. Eighty-nine (47%) patients had a prior diagnosis of epilepsy. Thirty-four (18%) patients had a history of SE. The time to the first benzodiazepine was similar in participants with and without a diagnosis of epilepsy (15 [5-60] vs 16.5 [5-42.75] minutes, p = 0.858). Patients with a diagnosis of epilepsy received their first non-benzodiazepine (BZD) antiepileptic drug (AED) later (93 [46-190] vs 50.5 [28-116] minutes, p = 0.002) and were less likely to receive at least one continuous infusion (35/89 [39.3%] vs 57/100 [57%], p = 0.03). Compared to patients with no history of SE, patients with a history of SE received their first BZD earlier (8 [3.5-22.3] vs 20 [5-60] minutes, p = 0.0073), although they had a similar time to first non-BZD AED (76.5 [45.3-124] vs 65 [32.5-156] minutes, p = 0.749). Differences were mostly driven by the patients with an out-of-hospital rSE onset. CONCLUSIONS: Our study establishes that children with rSE do not receive more timely treatment if they have a prior diagnosis of epilepsy; however, a history of SE is associated with more timely administration of abortive medication.
Authors: Syndi Seinfeld; Shlomo Shinnar; Shumei Sun; Dale C Hesdorffer; Xiaoyan Deng; Ruth C Shinnar; Kathryn O'Hara; Douglas R Nordli; L Matthew Frank; William Gallentine; Solomon L Moshé; John M Pellock Journal: Epilepsia Date: 2014-02-06 Impact factor: 5.864
Authors: Stuart Lewena; Victoria Pennington; Jason Acworth; Susan Thornton; Peter Ngo; Shona McIntyre; David Krieser; Jocelyn Neutze; Deirdre Speldewinde Journal: Pediatr Emerg Care Date: 2009-02 Impact factor: 1.454
Authors: Juma S Mbwana; Zachary M Grinspan; Russell Bailey; Madison Berl; Jeffrey Buchhalter; Adrian Bumbut; Zach Danner; Tracy Glauser; Angie Glotstein; Howard Goodkin; Brian Jacobs; Lisa Jones; Barbara Kroner; Gardiner Lapham; Tobias Loddenkemper; Demetrius M Maraganore; Doug Nordli; William D Gaillard Journal: Neurol Clin Pract Date: 2019-02
Authors: Theodore Sheehan; Marta Amengual-Gual; Alejandra Vasquez; Nicholas S Abend; Anne Anderson; Brian Appavu; Ravindra Arya; Cristina Barcia Aguilar; J Nicholas Brenton; Jessica L Carpenter; Kevin E Chapman; Justice Clark; Raquel Farias-Moeller; William D Gaillard; Marina Gaínza-Lein; Tracy A Glauser; Joshua L Goldstein; Howard P Goodkin; Réjean M Guerriero; Linda Huh; Michele Jackson; Kush Kapur; Robert Kahoud; Yi-Chen Lai; Tiffani L McDonough; Mohamad A Mikati; Lindsey A Morgan; Edward J Novotny; Adam P Ostendorf; Eric T Payne; Katrina Peariso; Juan Piantino; Latania Reece; James J Riviello; Tristan T Sands; Kumar Sannagowdara; Renee Shellhaas; Garnett Smith; Robert C Tasker; Dmitry Tchapyjnikov; Alexis A Topjian; Mark S Wainwright; Angus Wilfong; Korwyn Williams; Bo Zhang; Tobias Loddenkemper Journal: Epilepsia Date: 2021-08-21 Impact factor: 6.740
Authors: Iván Sánchez Fernández; Nicholas S Abend; Marta Amengual-Gual; Anne Anderson; Ravindra Arya; Cristina Barcia Aguilar; James Nicholas Brenton; Jessica L Carpenter; Kevin E Chapman; Justice Clark; Raquel Farias-Moeller; William D Gaillard; Marina Gaínza-Lein; Tracy Glauser; Joshua Goldstein; Howard P Goodkin; Réjean M Guerriero; Yi-Chen Lai; Tiffani McDonough; Mohamad A Mikati; Lindsey A Morgan; Edward Novotny; Eric Payne; Katrina Peariso; Juan Piantino; Adam Ostendorf; Tristan T Sands; Kumar Sannagowdara; Robert C Tasker; Dimtry Tchapyjnikov; Alexis A Topjian; Alejandra Vasquez; Mark S Wainwright; Angus Wilfong; Kowryn Williams; Tobias Loddenkemper Journal: Neurology Date: 2020-07-01 Impact factor: 9.910
Authors: I Sánchez Fernández; M Gaínza-Lein; N S Abend; A E Anderson; R Arya; J N Brenton; J L Carpenter; K E Chapman; J Clark; W D Gaillard; T A Glauser; J L Goldstein; H P Goodkin; A R Helseth; M C Jackson; K Kapur; Y-C Lai; T L McDonough; M A Mikati; A Nayak; K Peariso; J J Riviello; R C Tasker; D Tchapyjnikov; A A Topjian; M S Wainwright; A Wilfong; K Williams; T Loddenkemper Journal: Neurology Date: 2018-04-11 Impact factor: 9.910
Authors: Marina Gaínza-Lein; Cristina Barcia Aguilar; Juan Piantino; Kevin E Chapman; Iván Sánchez Fernández; Marta Amengual-Gual; Anne Anderson; Brian Appavu; Ravindra Arya; James Nicholas Brenton; Jessica L Carpenter; Justice Clark; Raquel Farias-Moeller; William D Gaillard; Tracy A Glauser; Joshua L Goldstein; Howard P Goodkin; Linda Huh; Robert Kahoud; Kush Kapur; Yi-Chen Lai; Tiffani L McDonough; Mohamad A Mikati; Lindsey A Morgan; Anuranjita Nayak; Edward Novotny; Adam P Ostendorf; Eric T Payne; Katrina Peariso; Latania Reece; James Riviello; Kumar Sannagowdara; Tristan T Sands; Theodore Sheehan; Robert C Tasker; Dmitry Tchapyjnikov; Alejandra Vasquez; Mark S Wainwright; Angus Wilfong; Korwyn Williams; Bo Zhang; Tobias Loddenkemper Journal: Epilepsia Date: 2021-07-12 Impact factor: 6.740