Clinical Characteristics Of Children With Refractory Status Epilepticus

Objective:To explore clinical characteristics in children with refractory status epilepticus (RSE), and to search treatment of optimization and risk factors for outcome.Method:A retrospective review was performed, a total of 804 cases of status epilepticus (SE) were identified in Children’s Hospital of Chongqing Medical University from Jan.2005 to Jan.2015. The clinical features were analyzed. The statistics was done by SPSS software for Windows.Result:(1) 76/804(9.5%) were RSE, most of them accompanying fever and consciousness impairment.37/76(48.7%) patients were with generalized tonic clonic seizure (GTCS), followed by complex partial complex seizure in 14 (18.4%) cases. (2) Infection of central nervous system and epilepsy as etiology were observed frequently in RSE, account for 48.7% and 27.6% respectively. (3)47 cases were effective for medicines, in which midazolam or/plus phenobarbital 34 times (72.3%). (4) Ordered logistic regression analysis showed that the higher temperature (> 39℃), the higher risk of death, the longer seizure onset to initial treatment interval (> 1h) and the longer hospitalization duration, the worse the outcome.Conclusion:(1) GTCS and complex partial complex seizure are observed frequently in our research. (2) Continuous intravenous infusion midazolam and/or phenobarbital should be the preferred method of treatment, if seizure continues propofol and other antiepileptic drugs should be taken into consideration. (3) The short-term prognosis of RSE may be related to temperature, the onset-initial treatment interval and hospitalization duration. It is suggested that emergent and efficient treatment to seizures should be performed as fast as possible to prevent occurrence of RSE for those children with SE, apart from aggressive treatment of the primary disease.