Abstracts

Rationale: To describe clinical features of patients at risk for status epilepticus (SE) and to identify SE predictors in hospitalized children admitted with seizures. Methods: We retrospectively reviewed medical records for all admissions for epilepsy at our institution over a four year period and compared clinical features of patients with history of SE to those without history of SE. Statistical analysis was conducted with non-parametric measures (Wilcoxon test). Logistic regression modeling was used to calculate odds ratios.Results: 1291 patients (54% male) were identified. Median patient age was 28 months (IQR 6-72). Overall, 553 children (42.8%) had one seizure type, and 738 (57.1%) experienced multiple seizure types; 553 (42.8%) had developmental delay, 422 (32.7%) presented with generalized tonic clonic seizures, 280 (21.7%) had abnormal EEGs, and 568 (44%) had abnormal MRI. We found 770 children (62%) on <2 antiepileptic drugs (AEDs), while 491 (38%) were on 2 or more AEDs. Overall, 669 (53%) had multiple admissions. Additionally, we identified 458 (35.5%) children with history of SE and 833 (64.5%) without history of SE. The odds of hospitalization with SE were 2.38 times higher in patients with multiple seizure types (P<0.0001), 2.43 times higher in patients with a known trigger or precipitant for seizures (p<0.0001), and 1.76 times higher in patients with a history of multiple admissions in the past (p<0.0001). Patients that never had a generalized tonic clonic seizure had lower odds of hospitalization with SE (OR 0.29; p<0.0001). Conclusions: These identified differences may contribute to predicting SE risk in hospitalized pediatric epilepsy patients. Prospective studies are necessary to identify biomarkers for SE risk in children with epilepsy (Supported by a Career Development Award, Office of Faculty Development, Harvard Medical School and Children s Hospital Boston).