Abstracts

Rationale: The aim of this study was to investigate the clinical and electroencephalographic (EEG) features and outcome in acute ill pediatric patients with nonconvulsive status epilepticus (NCSE). Methods: We retrospectively reviewed 22 patients (16 males and 6 females) with NCSE between May 2006 and March 2012 in the Pediatric Intensive Care Unit (PICU) of Seoul National University Children's Hospital. Results: The patients ranged in age from 1 month old to 22 years, with a mean age of 6.8 years of age. All patients were in a lethargic or comatose state at the time of diagnosis of NCSE. Presumed encephalitis was the most frequent etiology of NCSE in 11 (50.0%), followed by intracranial hemorrhage in 5 (22.7%), multi-organ failure form septic shock in 4 (18.1%), exacerbation of preexisting epilepsy in 3 (13.6%), exacerbation of underlying autoimmune disease in 1 (4.5%). There were four patients (18.1%) with generalized convulsive status epilepticus (GCSE) that was followed by NCSE and 15 patients (68.1%) developed NCSE after brief convulsive seizures. Three patients (13.6%) presented with NCSE as the first manifestation of seizure activity during a comatose state. EEG waveform morphologies were quite variable and included repetitive generalized or focal spikes, polyspike, sharp wave, spike and wave or sharp and slow wave complexes, or other rhythmic theta or delta activity. Three patients (13.6%) had generalized ictal discharges. Five patients (22.7%) died of the underlying acute medical illness. Conclusions: In this study, we presented that the clinical and EEG features in pediatric patients with NCSE. Common etiologies of NCSE are acute CNS lesions associated with serious underlying medical condition and presumed encephalitis. Prolonged EEG monitoring to exclude NCSE may be warranted in pediatric patients in comatose state even after brief convulsive seizure.