First results from the status Epilepticus Australasian registry for children (SEARCh). Multicentre, prospective, observational cohort study of paediatric status epilepticus
Journal Contribution ResearchOnline@JCUAbstract
Background: Status Epilepticus (SE) is the most frequent neurological emergency in children, with a high morbidity and mortality. There are no prospective national Australian emergency department (ED) data on SE. Objective: To determine clinical characteristics and management of SE in children in Australian EDs. Methods: Prospective, observational cohort study at 4 mixed and tertiary paediatric ED in Australia. Participants were included if presenting with SE (seizure duration >5 min). We present descriptive data on clinical characteristics and management as medians (IQR) using APLS dosing as gold standard. Results: 172 children were enrolled: age 4.0 years (1.8 to 8.5), weight 18.0 kg (12.3 to 26.8) and 50.0% were male. Seizure duration was 15.0 min (7.0 to 40.0). The majority of patients arrived by ambulance (73.8%) and had a history of prior seizures/epilepsy (67.4%). Benzodiazepines were administered by parents/caregivers 45/172 (26.2%), prehospital 58/172 (33.7%) and in ED, 43/172 (25.0%) and were administered after seizure onset at 12.5 min (7–18.1), 13.1 min (9.3–19.3) and 125 min (70–250) respectively. Median doses of benzodiazepines were 0.2 mg (0.1–0.3) and 0.2 (0.1–0.2). Second line drugs (phenytoin or leviteracetam) was administered in ED 21/172 (12.2%) of patients at 125.0 min (70.0–250.0). On discharge, the most common diagnosis was convulsive SE and focal motor SE with prominent motor signs. Disposition included 6.9% ICU and 93.1% ward. Conclusion: Children with SE are generally treated as per APLS guidelines. However, there is a large scope for earlier treatment with both benzodiazepines and second line drugs.
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Volume
32
ISBN/ISSN
1742-6723
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Issue
S1
Pages Count
2
Location
Hobart, TAS, Australia
Publisher
Wiley-Blackwell
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DOI
10.1111/1742-6723.13475