Abstracts

Rationale: Status Epilepticus (SE) is the commonest neurological emergency in childhood. Aim of this study is to report a large cohort of pediatric patients suffering from Status Epilepticus (SE) applying the International League Against Epilepsy (ILAE) Classification for SE in order to identify prognostic factors. Methods: We included 173 children treated at 'Bambino Gesù' Children's Hospital in Rome (4.43+-4.93 years old; follow up 4.9+-3.4 years). Multivariate model was constructed to predict neurocognitive outcome, recurrence of SE, development of epilepsy and mortality. Adjusted ORs were calculated with 95% Confidence interval (OR [95%CI]). Results: We observed a different prevalence of aetiologies for the different semiologies (p <0.05) and for each age-group (p <0.05), overlapping only in part with the recent ILAE classification. After SE, patients showed: 69.9% epilepsy (drug-resistant in half of them), 23.1% worsening of neurological examination, 28.9 % cognitive deficit, 28.3 % recurrent SE. At multivariate analysis: super-refractory SE was correlated to an increased risk of developing cognitive (OR 6.00[2.09, 17.31]) or neurologic sequelae (OR 4.9[1.75, 19.77]). A similar finding was observed for patients with onset in neonatal period for cognitive (OR 4.84[1.13, 17.3]) and neurologic sequelae (OR 9.03[2.40, 34.04]).Recurrence of SE was associated with unknown aetiology (OR 6.15[1.43, 26.76]), and myoclonic semiology (OR 6.1[1.23, 29.3]). Patients with acute symptomatic aetiology (OR 0.12[0.04, 0.40]) had a lower risk to develop epilepsy.  Conclusions: Age at onset and duration of SE are critical independent variables associated to worst neurocognitive outcome. The risk to develop epilepsy is lower after acute symptomatic and febrile SE. Semiology and age of onset are useful to predict aetiology of SE. For this reason, ILAE classification respect the 4 axes seems to be a good step forward. Funding: No funding