scholarly journals Treatment of Generalized Convulsive Status Epilepticus in Pediatric Patients

2015 ◽  
Vol 20 (4) ◽  
pp. 260-289
Author(s):  
Elizabeth L. Alford ◽  
James W. Wheless ◽  
Stephanie J. Phelps
Keyword(s):  
Status Epilepticus ◽  
Pediatric Patients ◽  
Life Support ◽  
Morbidity And Mortality ◽  
Convulsive Status Epilepticus ◽  
Significant Morbidity ◽  
Support Measures ◽  
Neurologic Emergencies ◽  
Underlying Causes

Generalized convulsive status epilepticus (GCSE) is one of the most common neurologic emergencies and can be associated with significant morbidity and mortality if not treated promptly and aggressively. Management of GCSE is staged and generally involves the use of life support measures, identification and management of underlying causes, and rapid initiation of anticonvulsants. The purpose of this article is to review and evaluate published reports regarding the treatment of impending, established, refractory, and super-refractory GCSE in pediatric patients.

Evaluation of an Electronic Dosing Calculator to Reduce Pediatric Medication Errors

2019 ◽  
Vol 58 (4) ◽  
pp. 413-416
Author(s):  
Brian Murray ◽  
Matthew J. Streitz ◽  
Michael Hilliard ◽  
Joseph K. Maddry
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Prospective Cohort ◽  
Pediatric Patients ◽  
Cohort Analysis ◽  
Morbidity And Mortality ◽  
Patient Visit ◽  
Significant Morbidity ◽  
Potential Source ◽  
Medication Dosage

Introduction. Adverse medication events are a potential source of significant morbidity and mortality in pediatric patients, where dosages frequently rely on weight-based formulas. The most frequent occurrence of medication errors occurs during the ordering phase. Methods. Through a prospective cohort analysis, we followed medication errors through patient safety reports (PSRs) to determine if the use of a medication dosage calculator would reduce the number of PSRs per patient visits. Results. The number of PSRs for medication errors per patient visit occurring due to errors in ordering decreased from 10/28 417 to 1/17 940, a decrease by a factor of 6.31, with a χ2 value of 4.063, P = .0463. Conclusion. We conclude that the use of an electronic dosing calculator is able to reduce the number of medication errors, thereby reducing the potential for serious pediatric adverse medication events.

scholarly journals Association of guideline publication and delays to treatment in pediatric status epilepticus

Neurology ◽  
2020 ◽  
Vol 95 (9) ◽  
pp. e1222-e1235
Author(s):  
Iván Sánchez Fernández ◽  
Nicholas S. Abend ◽  
Marta Amengual-Gual ◽  
Anne Anderson ◽  
Ravindra Arya ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Status Epilepticus ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Pediatric Patients ◽  
Convulsive Status Epilepticus ◽  
Hospital Arrival ◽  
Time To Treatment ◽  
Patient Interviews ◽  
Record Review

ObjectiveTo determine whether publication of evidence on delays in time to treatment shortens time to treatment in pediatric refractory convulsive status epilepticus (rSE), we compared time to treatment before (2011–2014) and after (2015–2019) publication of evidence of delays in treatment of rSE in the Pediatric Status Epilepticus Research Group (pSERG) as assessed by patient interviews and record review.MethodsWe performed a retrospective analysis of a prospectively collected dataset from June 2011 to September 2019 on pediatric patients (1 month–21 years of age) with rSE.ResultsWe studied 328 patients (56% male) with median (25th–75th percentile [p25–p75]) age of 3.8 (1.3–9.4) years. There were no differences in the median (p25–p75) time to first benzodiazepine (BZD) (20 [5–52.5] vs 15 [5–38] minutes, p = 0.3919), time to first non-BZD antiseizure medication (68 [34.5–163.5] vs 65 [33–142] minutes, p = 0.7328), and time to first continuous infusion (186 [124.2–571] vs 160 [89.5–495] minutes, p = 0.2236). Among 157 patients with out-of-hospital onset whose time to hospital arrival was available, the proportion who received at least 1 BZD before hospital arrival increased after publication of evidence of delays (41 of 81 [50.6%] vs 57 of 76 [75%], p = 0.0018), and the odds ratio (OR) was also increased in multivariable logistic regression (OR 4.35 [95% confidence interval 1.96–10.3], p = 0.0005).ConclusionPublication of evidence on delays in time to treatment was not associated with improvements in time to treatment of rSE, although it was associated with an increase in the proportion of patients who received at least 1 BZD before hospital arrival.

Status Epilepticus: Work-Up and Management in Adults

2020 ◽  
Vol 40 (06) ◽  
pp. 652-660
Author(s):  
Assia Meziane-Tani ◽  
Brandon Foreman ◽  
Moshe A. Mizrahi
Keyword(s):  
United States ◽  
Status Epilepticus ◽  
Drug Administration ◽  
Baby Boomer ◽  
The United States ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Neurological Emergencies ◽  
Work Up

AbstractStatus epilepticus is one of the most common neurological emergencies and is likely to have increasing prevalence in coming years given an aging “baby boomer” population in the United States. Because status epilepticus is associated with significant morbidity and mortality, identification and treatment are paramount. Care should be taken to exclude nonorganic mimics and infectious and metabolic causes. Status epilepticus can be classified into stages with associated recommendations for escalation in therapy, increasing from push-dose benzodiazepines to continuous anesthetic infusions and other nontraditional therapies. Concurrent electroencephalogram monitoring helps to identify, localize, and assess resolution of ictal patterns alongside antiseizure drug administration. A protocol is proposed for the management of status epilepticus in a step-wise fashion.

Status Epilepticus in Children: Update and Review

1994 ◽  
Vol 9 (2_suppl) ◽  
pp. 2S27-2S35 ◽  
Author(s):  
John M. Pellock
Keyword(s):  
Status Epilepticus ◽  
Young Children ◽  
Medical Therapy ◽  
Morbidity And Mortality ◽  
Convulsive Status Epilepticus ◽  
Elderly Adults ◽  
Neurologic Emergency ◽  
Improved Outcome

This report presents a brief description and classification of status epilepticus. This neurologic emergency occurs more frequently in young children and elderly adults, although patients of all ages may experience prolonged seizures. The pathophysiology and prognosis of the disorder are presented, as well as a review of drugs commonly used for the treatment of convulsive status epilepticus. The morbidity and mortality of status epilepticus are significant and directly dependent upon prompt and appropriate medical therapy. Advances in understanding various aspects of status epilepticus may lead to improved outcome for affected patients. (J Child Neurol 1994;9(Suppl):2S27-2S35).

scholarly journals Association of Time to Treatment With Short-term Outcomes for Pediatric Patients With Refractory Convulsive Status Epilepticus

2018 ◽  
Vol 75 (4) ◽  
pp. 410 ◽  
Author(s):  
Marina Gaínza-Lein ◽  
Iván Sánchez Fernández ◽  
Michele Jackson ◽  
Nicholas S. Abend ◽  
Ravindra Arya ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Pediatric Patients ◽  
Convulsive Status Epilepticus ◽  
Short Term ◽  
Time To Treatment

scholarly journals NONCONVULSIVE STATUS EPILEPTICUS CAUSED BY VIRAL ENCEPHALITIS: CASE REPORT

2015 ◽  
Vol 14 (1) ◽  
pp. 42-45
Author(s):  
Rodica Cozac ◽  
◽  
Lilia Rotaru ◽  
◽  
Keyword(s):  
Status Epilepticus ◽  
Pediatric Patients ◽  
Serum Antibody ◽  
Occipital Lobe ◽  
Antibody Test ◽  
Good Health ◽  
Altered Mental Status ◽  
Convulsive Status Epilepticus ◽  
Barr Virus ◽  
Ebv Infection

In pediatric patients Epstein-Barr virus (EBV) infection may have miscellaneous neurological manifestations. Children with acute viral encephalopathy may present prolonged electrographic seizure activity consistent with non-convulsive status epilepticus (NCSE). NCSE condition is difficult to diagnose due to absence of motor seizures, presenting only changes in behavior and consciousness. In this report we present a clinical case of EBV infection in 3.5-year-old girl. On admission she suffered of confusional state and irritability after an episode of motor partial complex seizure being in good health. The condition evolved twenty five days after an episode of respiratory infection diagnosed as bacterial tonsillitis by the family physician and treated with antibacterials. Laboratory blood evaluation as well as chest radiography, urinalysis, bleeding time, fibrinogen were within the normal range. Magnetic resonance imaging of the brain and spinal cord revealed a subcortical increased signal in the left occipital lobe on T2-weighted image. Electroencephalography (EEG) pattern revealed non-convulsive status epilepticus (NCSE). EBV infection was revealed by serum antibody test. The present case emphasizes the importance to evaluate the role of EBV in acute neurological syndromes in pediatric patients, in particular, in presence of behavioral changes with EEG evidence of seizures. NCSE in children denotes electrographic seizures without convulsive activity and often manifests as altered mental status. It may be difficult to diagnose in pediatric patients in whom changes of behavior and consciousness may not be as easily recognized as in adults.

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