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INTERNATIONAL JOURNAL OF CREATIVE RESEARCH THOUGHTS - IJCRT (IJCRT.ORG)
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REFRACTORY AND SUPER-REFRACTORY CONVULSIVE STATUS EPILEPTICUS OF CHILDREN IN THE WEST OF ALGERIA: RISK FACTORS.
Authors
BOUMENDIL Dalila,SELLAM Abdelnour,CHENNI Karima ,MENTOURI Zahia
Downlaod Center
Keywords
Refractory status epilepticus; Super-Refractory status epilepticus; Etiology; PICU; Outcome; Children.
Abstract
Introduction
Refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) are serious and frequent neurological emergencies in children associated with high morbidity and mortality. Despite this, we note the absence of published Algerian data. The aim of this work is to determine the demographic data, the etiologies and the factors of progression in RCSE and Super-RCSE as well as the short-term prognosis.
Design: Prospective observational study with retrospective analysis of all the episodes of RCSE and Super-RCSE treated between January 1, 2008, and April 30, 2016.
Setting: Pediatric Intensive Care Unit, University Hospital of Oran, Algeria.
Patients:
RCSE is defined as seizure activity that persists after administration of a first-line benzodiazepine (BZD) and a second-line antiepileptic drug (AED). Super-RCSE is defined as �SE that has continues or recurred despite 24 hours of general anesthesia. �
Factors independently associated with Refractory and Super-RCSE were established through univariate and multivariable analyses. The outcome was evaluated using the Glasgow Outcome Score.
Results:
Among 443 patients with status epilepticus, 140 patients (31.6%) were afflicted with refractory status epilepticus and 25 (5.6%) with SRSE. The mean age of the entire cohort was 40.65 � 2.16 months [1 � 180 months].135 patients (33.8%) had suffered previous seizures;
RCSE was related to younger age (< 3 years) (OR 1.76; 95% CI 1,018 � 3,058) p=0.043, duration of status epilepticus >2 h (OR 3.096; 95% CI 1, 77 � 5, 39) p= 10??, acute symptomatic etiologies (OR 3.609; 95% CI 2,112 � 6.166), Severe consciousness impairment (GCS < 13/15) before treatment (OR 18.55; 95% CI 8,202 � 41.972) p= 10?? and Non respect of the therapeutic protocol upstream of PICU (OR 3.659; 95% CI 1,926 � 6.949) p= 10??.
Super-RCSE was independently associated with age greater than 3 years (OR 3.28; p=0.018), indeterminate etiology (OR 6.628; p=0.009), encephalitis (OR 4. 782; p=0.003) and use of Vasopressor medications (OR 4.239; p=0.007). Overall mortality was 83 (20.75%).
Conclusion
The etiologies of CSE are heterogeneous, with significant incidence of RCSE in acute symptomatic group.
Encephalitis was the determinant of progression of CSE to Super-RCSE.
The therapeutic success of which depends on whether or not the cause of CSE can be treated.
IJCRT's Publication Details
Unique Identification Number - IJCRT2006603
Paper ID - 196348
Author type - Foreign Author
Page Number(s) - 4437-4445
Pubished in - Volume 8 | Issue 6 | June 2020
DOI (Digital Object Identifier) -
No Of Downloads - 1406
Author Country - 31000, Algeria , Oran, Oran, Algeria , Medical Science
Publisher Name - IJPUBLICATION | www.ijcrt.org | ISSN : 2320-2882
E-ISSN Number - 2320-2882
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BOUMENDIL Dalila,SELLAM Abdelnour,CHENNI Karima ,MENTOURI Zahia , "REFRACTORY AND SUPER-REFRACTORY CONVULSIVE STATUS EPILEPTICUS OF CHILDREN IN THE WEST OF ALGERIA: RISK FACTORS. ", International Journal of Creative Research Thoughts (IJCRT), ISSN:2320-2882, Volume.8, Issue 6, pp.4437-4445, June 2020, Available at :http://www.ijcrt.org/papers/IJCRT2006603.pdf
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