Nonconvulsive seizures are common in critically ill children.
Publication/Presentation Date
3-22-2011
Abstract
BACKGROUND: Retrospective studies have reported the occurrence of nonconvulsive seizures in critically ill children. We aimed to prospectively determine the incidence and risk factors of nonconvulsive seizures in critically ill children using predetermined EEG monitoring indications and EEG interpretation terminology.
METHODS: Critically ill children (non-neonates) with acute encephalopathy underwent continuous EEG monitoring if they met institutional clinical practice criteria. Study enrollment and data collection were prospective. Logistic regression analysis was utilized to identify risk factors for seizure occurrence.
RESULTS: One hundred children were evaluated. Electrographic seizures occurred in 46 and electrographic status epilepticus occurred in 19. Seizures were exclusively nonconvulsive in 32. The only clinical risk factor for seizure occurrence was younger age (p=0.03). Of patients with seizures, only 52% had seizures detected in the first hour of monitoring, while 87% were detected within 24 hours.
CONCLUSIONS: Seizures were common in critically ill children with acute encephalopathy. Most were nonconvulsive. Clinical features had little predictive value for seizure occurrence. Further study is needed to confirm these data in independent high-risk populations, to clarify which children are at highest risk for seizures so limited monitoring resources can be allocated optimally, and to determine whether seizure detection and management improves outcome.
Volume
76
Issue
12
First Page
1071
Last Page
1077
ISSN
1526-632X
Published In/Presented At
Abend, N. S., Gutierrez-Colina, A. M., Topjian, A. A., Zhao, H., Guo, R., Donnelly, M., Clancy, R. R., & Dlugos, D. J. (2011). Nonconvulsive seizures are common in critically ill children. Neurology, 76(12), 1071–1077. https://doi.org/10.1212/WNL.0b013e318211c19e
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
21307352
Department(s)
Department of Pediatrics
Document Type
Article