Etiology and mortality of status epilepticus in children. A recent update

Abstract

We reviewed the medical records of 218 episodes of status epilepticus in 193 children who were admitted to the hospital between 1983 and 1987. Of the episodes, 61% were in boys and 39% in girls, with an age range of 1 month to 14 years (average, 3.2 years). The majority of episodes (73%) occurred in patients who were less than 5 years old, with 61% less than 3 years old and 28% less than 1 year old. Status epilepticus as the initial seizure occurred in 71% of episodes. In patients under 1 year of age, 75% of episodes were associated with acute causes (bacterial meningitis in 28% and electrolyte disorders in 30%), and 23% were idiopathic (19% associated with fever). In children less than 3 years old, 47% of episodes had an acute cause, 9% had a previously known seizure disorder, and 32% were idiopathic (30% associated with fever). In patients older than 3 years, 28% of episodes were associated with acute causes, 38% were known epileptics, and 13% were idiopathic (11% had fever). Overall mortality was 6%, with 1% of all episodes ending in death during the presenting seizure. We conclude that the etiology of status epilepticus is age related, with acute causes being more common in patients with a younger age at presentation. When our data are compared with other large studies in children, it appears that mortality associated with status epilepticus has decreased.