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Childhood convulsive status epilepticus: epidemiology, management and outcome
Author(s) -
Neville B. G. R.,
Chin R. F. M.,
Scott R. C.
Publication year - 2007
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2007.00805.x
Subject(s) - medicine , lorazepam , epidemiology , status epilepticus , incidence (geometry) , etiology , pediatrics , diazepam , phenytoin , midazolam , anesthesia , mortality rate , epilepsy , psychiatry , physics , sedation , optics
Convulsive status epilepticus (CSE) in childhood is a medical emergency and its aetiology and outcome mean that it should be studied separately from adult CSE. The incidence in developed countries is between 17 and 23/100,000 with a higher incidence in younger children. Febrile CSE is the commonest single group with a good prognosis in sharp distinction to CSE related to central nervous system infections which have a high mortality. The aim of treatment is to intervene at 5 min and studies indicate that intravenous (i.v.) lorazepam may be a better first‐line treatment than rectal diazepam and i.v. phenytoin a better second‐line treatment than rectal paraldehyde. An epidemiological study strongly supports the development of prehospital treatment with buccal midazolam becoming a widely used but unlicensed option in the community. More than two doses of benzodiazepines increase the rate of respiratory depression without obvious benefit. The 1 year recurrence rate is 17% and the hospital mortality is about 3%.