Abstracts

There is little published data on the expected duration of depressed consciousness following epileptic seizures. A previous study from our group found that median recovery time in children from epileptic seizures involving impaired consciousness was 43 minutes, with febrile seizures recovering more quickly (median 15 minutes). There was a trend for recovery time following symptomatic seizures to be longer than that following idiopathic and febrile seizures, but patient numbers were too small to demonstrate this conclusively. This paediatric prospective cohort study investigates recovery time following symptomatic seizures, compared to those of other aetiologies., Children aged 1-16 years presenting to two Accident and Emergency departments and paediatric wards in Leeds hospitals (United Kingdom), suffering a witnessed seizure in which consciousness was impaired, were studied. Hourly coma scores were performed, using the Modified Paediatric Coma Scale, until a score of 15 was reached. Seizures were classified as febrile, idiopathic, remote and acute symptomatic. Factors which affect recovery time were investigated using the Poisson Regression model (p[lt]0.05)., Data from 99 seizures suffered by 75 children (33 males) was obtained. Seizures were classified as: acute symptomatic seizures (n=26); remote symptomatic (n=49); and idiopathic (n=24). Recovery in hours was significantly prolonged in those children (n=40) receiving emergency antiepileptic medication, 4.66 [plusmn] 1.64-9.21 (median hours [plusmn] interquartile range) versus 1.0 [plusmn] 0.3-2.0 in those (n=59) not receiving medication (95% confidence interval [CI] 1.11-1.68, p=0.003). Acute symptomatic seizures took longer to recover (1.94 [plusmn] 0.2-9.12) than those of other aetiologies (remote symptomatic 1.5 [plusmn] 0.92-6.31, idiopathic 0.83 [plusmn] 0.3-2.68). When acute symptomatic seizures were compared with data for febrile seizures from our previous study (n=59), recovery was significantly longer (0.3 [plusmn] 0.15-0.7, 95% CI 0.46-0.95, p=0.024). Acute symptomatic seizures occurring in children with prior neurological abnormalities (acute on remote) took longer to recover than all other groups (4.0 [plusmn] 0.89-10.5). Age, sex, type and duration of seizure had no affect on recovery time., Symptomatic seizures take longer to recover than seizures of other aetiologies, particularly febrile seizures. The [apos]acute on remote[apos] group has not been previously identified and warrants further investigation. It is recommended that a child who presents with a seizure and a fever, who has not fully recovered within 1 hour, should be investigated for an acute symptomatic aetiology.,