Time to treatment in pediatric patients with repeated episodes of status epilepticus

被引:0
作者
Gettings, Jennifer V. [1 ]
Fernandez, Ivan Sanchez [1 ,2 ]
Anderson, Anne [3 ]
Brenton, J. Nicholas [4 ]
Can, Afra [5 ]
Clark, Justice [1 ]
Moeller, Raquel Farias [6 ]
Goodkin, Howard P. [4 ]
Lai, Yi-Chen [7 ]
Mikati, Mohamad A. [8 ]
Morgan, Lindsey A. [9 ]
Novotny, Edward [9 ,10 ]
Ostendorf, Adam P. [11 ]
Piantino, Juan [12 ]
Riviello, James J. [3 ]
Sannagowdara, Kumar [13 ]
Tasker, Robert C. [14 ,15 ]
Tchapyjnikov, Dmitry [16 ]
Wainwright, Mark S. [9 ]
Wilfong, Angus [17 ,18 ]
Williams, Korwyn [17 ,18 ]
Zhang, Bo [19 ,20 ]
Loddenkemper, Tobias [1 ]
Gainza-Lein, Marina [1 ,21 ,22 ]
机构
[1] Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Epilepsy & Clin Neurophysiol, Boston, MA 02115 USA
[2] Univ Barcelona, Hosp St Joan Deu, Dept Child Neurol, Barcelona, Spain
[3] Texas Childrens Hosp, Baylor Coll Med, Dept Pediat, Div Neurol & Dev Neurosci, Houston, TX USA
[4] Univ Virginia, Dept Neurol & Pediat, Charlottesville, VA USA
[5] Univ Rochester, Med Ctr, Dept Neurol, Div Child Neurol, Rochester, NY USA
[6] Childrens Hosp Wisconsin, Med Coll Wisconsin, Dept Neurol, Div Pediat Neurol, Milwaukee, WI USA
[7] Baylor Coll Med, Dept Pediat, Div Pediat Crit Care Med, Houston, TX USA
[8] Duke Univ, Med Ctr, Div Pediat Neurol, Durham, NC USA
[9] Univ Washington, Seattle Childrens Hosp, Dept Neurol, Div Child Neurol, Seattle, WA USA
[10] Seattle Childrens Res Inst, Norcliffe Fdn, Ctr Integrat Brain Res, Seattle, WA USA
[11] Ohio State Univ, Nationwide Childrens Hosp, Dept Pediat, Columbus, OH USA
[12] Oregon Hlth & Sci Univ, Doernbecher Childrens Hosp, Div Neurol, Portland, OR USA
[13] Advocate Aurora Hlth Care, Child Neurol, Epilepsy, Greenfield, WI USA
[14] Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Div Crit Care, Boston, MA USA
[15] Harvard Med Sch, Boston Childrens Hosp, Dept Anesthesiol Perioperat & Pain Med, Div Crit Care, Boston, MA USA
[16] Logan Hlth Childrens Med Ctr, Kallispell, MT USA
[17] Univ Arizona, Coll Med, Dept Child Hlth, Phoenix, AZ USA
[18] Phoenix Childrens Hosp, Barrow Neurol Inst, Phoenix, AZ USA
[19] Harvard Med Sch, Boston Childrens Hosp, Dept Neurol, Boston, MA USA
[20] Harvard Med Sch, Boston Childrens Hosp, Biostat & Res Design Ctr, Inst Ctr Clin & Translat Res, Boston, MA USA
[21] Univ Austral Chile, Fac Med, Inst Pediat, Independencia 631, Valdivia, Chile
[22] Univ Chile, Fac Med, Santiago, Chile
关键词
Status epilepticus; Refractory status epilepticus; Benzodiazepines; Anti-seizure medications; Treatment delay; CONVULSIVE STATUS EPILEPTICUS; REFRACTORY STATUS EPILEPTICUS; CHILDREN; MANAGEMENT; EPILEPSY; RECURRENCE; OUTCOMES; ADULTS;
D O I
10.1186/s12883-025-04200-w
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective To compare pediatric patients who presented with repeated status epilepticus episodes to patients with a single episode of status epilepticus and identify distinguishing clinical factors. Methods Retrospective analysis of a multicenter, prospective observational cohort of pediatric patients with status epilepticus between 2011 and 2019. Results Out of 504 status epilepticus episodes in 420 patients, 50 patients (10.3%) had repeated episodes of status epilepticus. The only predictor of repeated status epilepticus was a prior diagnosis of epilepsy. There was no difference in time to treatment with the first benzodiazepine in patients presenting with their first status epilepticus episode compared to their second status epilepticus episode [median 10 (interquartile range 5-30) vs. 14 (4.5-52.5) minutes; (p = 0.24)] or in time to treatment with the first non- benzodiazepine anti-seizure medication (ASM) [61 (37-125) vs. 71 (34.5-117.5) minutes; p = 0.61]. In patients with repeated status epilepticus episodes with onset outside the hospital, the percentage of patients treated by caregivers did not improve between the first and second status epilepticus episode (61% vs. 60%, p = 0.56). However, the time to first benzodiazepine was shorter in patients treated by caregivers compared to those who were not [5 (0-25) vs. 55 (41-120) minutes; p < 0.001]. Conclusions Time to treatment with benzodiazepine and non-benzodiazepine ASM in patients with repeated episodes of status epilepticus does not improve for a second episode of status epilepticus, suggesting additional opportunities for intervention and teaching.
引用
收藏
页数:11
相关论文
共 38 条
[1]  
Aguilar CB., 2024, Lack of association of first and second-line medication dosing and progression to refractory status epilepticus in children, V123, P133
[2]   Practice variability and efficacy of clonazepam, lorazepam, and midazolam in status epilepticus: A multicenter comparison [J].
Alvarez, Vincent ;
Lee, Jong Woo ;
Drislane, Frank W. ;
Westover, M. Brandon ;
Novy, Jan ;
Dworetzky, Barbara A. ;
Rossetti, Andrea O. .
EPILEPSIA, 2015, 56 (08) :1275-1285
[3]   Generalized convulsive status epilepticus management in adults: A cohort study with evaluation of professional practice [J].
Aranda, Alexandre ;
Foucart, Guillaume ;
Ducasse, Jean Louis ;
Grolleau, Sabrina ;
McGonigal, Aileen ;
Valton, Luc .
EPILEPSIA, 2010, 51 (10) :2159-2167
[4]   Readmission after seizure discharge in a nationally representative sample [J].
Blank, Leah J. ;
Crispo, James A. G. ;
Thibault, Dylan P. ;
Davis, Kathryn A. ;
Litt, Brian ;
Willis, Allison W. .
NEUROLOGY, 2019, 92 (05) :E429-E442
[5]   Guidelines for the Evaluation and Management of Status Epilepticus [J].
Brophy, Gretchen M. ;
Bell, Rodney ;
Claassen, Jan ;
Alldredge, Brian ;
Bleck, Thomas P. ;
Glauser, Tracy ;
LaRoche, Suzette M. ;
Riviello, James J., Jr. ;
Shutter, Lori ;
Sperling, Michael R. ;
Treiman, David M. ;
Vespa, Paul M. .
NEUROCRITICAL CARE, 2012, 17 (01) :3-23
[6]   Protocol-Driven Management of Convulsive Status Epilepticus at a Tertiary Children's Hospital: A Quality Improvement Initiative [J].
Cassel-Choudhury, Gina ;
Beal, Jules ;
Longani, Neha ;
Leone, Bridget ;
Rivera, Ruby ;
Katyal, Chhavi .
PEDIATRIC CRITICAL CARE MEDICINE, 2019, 20 (01) :47-53
[7]   A systematic review of the epidemiology of status epilepticus [J].
Chin, RFM ;
Neville, BGR ;
Scott, RC .
EUROPEAN JOURNAL OF NEUROLOGY, 2004, 11 (12) :800-810
[8]   Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study [J].
Chin, Richard F. M. ;
Neville, Brian G. R. ;
Peckham, Catherine ;
Bedford, Helen ;
Wade, Angela ;
Scott, Rod C. .
LANCET, 2006, 368 (9531) :222-229
[9]  
Eriksson Kai, 2005, Expert Rev Neurother, V5, P777, DOI 10.1586/14737175.5.6.777
[10]   Refractory status epilepticus in children with and without prior epilepsy or status epilepticus [J].
Fernandez, Ivan Sanchez ;
Jackson, Michele C. ;
Abend, Nicholas S. ;
Arya, Ravindra ;
Brenton, James N. ;
Carpenter, Jessica L. ;
Chapman, Kevin E. ;
Gaillard, William D. ;
Gainza-Lein, Marina ;
Glauser, Tracy A. ;
Goldstein, Joshua L. ;
Goodkin, Howard P. ;
Helseth, Ashley ;
Kapur, Kush ;
McDonough, Tiffani L. ;
Mikati, Mohamad A. ;
Peariso, Katrina ;
Riviello, James, Jr. ;
Tasker, Robert C. ;
Topjian, Alexis A. ;
Wainwright, Mark S. ;
Wilfong, Angus ;
Williams, Korwyn ;
Loddenkemper, Tobias .
NEUROLOGY, 2017, 88 (04) :386-394