https://scholars.lib.ntu.edu.tw/handle/123456789/527353
標題: | The etiology and prognosis of super-refractory convulsive status epilepticus in children | 作者: | Lu W.-Y. WEN-CHIN WENG LEE-CHIN WONG WANG-TSO LEE |
公開日期: | 2018 | 出版社: | Academic Press Inc. | 卷: | 86 | 起(迄)頁: | 66-71 | 來源出版物: | Epilepsy and Behavior | 摘要: | Background: Both refractory convulsive status epilepticus (SE) and super-refractory SE are medical emergencies. However, there are limited data on super-refractory SE in children. Thus, this study focuses on characterizing the demographics, outcomes, and prognostic factors for super-refractory SE in children. Methods: This study was a retrospective analysis of super-refractory SE treated in a tertiary referral center in Taiwan. The functional outcome was evaluated by modified Rankin scale (mRS). Significant functional decline was defined as an mRS difference (before hospital admission and at discharge) of more than 2. The variates and the follow-up mRS values were then analyzed statistically. Results: We enrolled 134 patients with 191 episodes of convulsive SE and identified 30 patients with 38 episodes of convulsive super-refractory SE. The incidence of convulsive super-refractory SE in the group with SE was 19.9%, and the age ranged from 2.5 months to 17 years. In-hospital mortality was 13.3%, which was much lower than that of adult cohorts. Newly acquired epilepsy and cognitive deficit occurred in 100% and 88.5%, respectively. Newly acquired epilepsy, as a sequel of super-refractory SE, was observed in all 18 patients (100%) who survived and had no history of epilepsy. Significant functional decline (mRS difference of more than 2) at discharge occurred in 76.7%. Poor functional outcome was associated with acute symptomatic etiology (P < 0.001) and the number of anesthetic agents (P = 0.002). The functional outcome improved after 1 year of follow-up in our population. Conclusions: Super-refractory SE is associated with significant morbidity and mortality in children. However, the in-hospital mortality rate is much lower compared with adults. The functional outcome in children is associated with acute symptomatic etiology and the number of anesthetic agents and may improve after long-term follow-up. ? 2018 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049495185&doi=10.1016%2fj.yebeh.2018.06.029&partnerID=40&md5=11fdcb55db2ef084d95e25e9cc8ae6c7 https://scholars.lib.ntu.edu.tw/handle/123456789/527353 |
ISSN: | 1525-5050 | DOI: | 10.1016/j.yebeh.2018.06.029 | SDG/關鍵字: | ketamine; midazolam; phenobarbital; phenytoin; propofol; thiamylal; thiopental; anesthetic agent; adolescent; age distribution; Article; child; cognitive defect; cohort analysis; controlled study; cortical dysplasia; demography; epileptic state; epileptogenesis; female; follow up; functional assessment; functional disease; hospital admission; hospital discharge; hospital mortality; human; infant; ketogenic diet; length of stay; major clinical study; male; morbidity; outcome assessment; prognosis; Rankin scale; retrospective study; risk factor; super refractory convulsive status epilepticus; survival rate; Taiwan; tertiary care center; treatment duration; anesthesia; cognitive defect; drug resistant epilepsy; epileptic state; hospitalization; incidence; intensive care; mortality; preschool child; prognosis; psychology; treatment outcome; Adolescent; Anesthesia; Anesthetics; Child; Child, Preschool; Cognitive Dysfunction; Critical Care; Drug Resistant Epilepsy; Female; Hospital Mortality; Hospitalization; Humans; Incidence; Length of Stay; Male; Prognosis; Retrospective Studies; Status Epilepticus; Treatment Outcome |
顯示於: | 醫學系 |
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