The Clinical Features And Risk Factors Of 403 Episodes Of Pediatric Status Epilepticus

Purpose To summarize the clinical characteristics of childhood status epilepticus in Shenzhen Children’s Hospital,and to analyze the affecting factors of etiology and the risk factors between non-refractory status epilepticus and refractory status epilepticus.Method In this study,403 episodes of status epilepticus conformed to the diagnosis standard according to the ILAE guideline of status epilepticus published in 2015.And we enrolled 348 patients from January 2016 to December 2018.Percentage,constituent ratio and quartile were used to describe the categorical and measurement data.Kruskal-Wallis test was used to compare the median of measurement data that did not conform to the normal distribution.Chi-square test or Fisher’s exact test was used to evaluate the relationship between affecting factors and etiology or extent of drug-resistant.Logistic regression analysis was used to evaluate the risk factors of them.When the α was 0.05,P<0.05 indicated statistically significant difference.SPSS 21 was used as the statistical software.Result1.Clinical characteristics: Patients in this study aged from 1 month to 15.5 years old,and the quartile was 2.43(1.05,4.92)years old.The male to female ratio was 1.4:1.The main seizure type was seizure with motor symptoms(91.8%).42.2% of these episodes were due to cryptogenic etiology,and followed by electro-clinical syndromes(24.1%).Epilepsy due to unknown reason was the main kind of diseases.Non-refractory status epilepticus,refractory status epilepticus and super-refractory status epilepticus accounted for 66.0%,26.3%,7.7%,respectively.2.The affecting factors of etiology: there were statistically significance among etiology in gender,age,seizure type(P<0.05).3.The risk factors of the progression of status epilepticus: age,seizure type and etiology were associated with the refractory extent of status epilepticus(P<0.05),while gender was not.Conclusion1.Clinical features: The percentage of patients with status epilepticus was slightly higher in male than female.The most common seizure type was status epilepticus with motor symptoms.More than half of the episodes of status epilepticus were non-refractory.The most common etiology and disease was cryptogenic and epilepsy due to unknown reason,respectively.2.Most of status epilepticus happened under 7 years old,and they were more likely to suffer from febrile status epilepticus.3.Patients with progressive etiology were more likely to have non-convulsive seizure.Non-convulsive status epilepticus could become refractory easily.4.Patients with progressive etiology were more likely to deteriorate to refractory or super-refractory status epilepticus.Among them,genetic metabolic diseases and mitochondrial diseases were the highest risk factors,followed by cerebrovascular disease and children acute toxic-metabolic encephalopathy.