RISK FACTORS OF NONCONVULSIVE STATUS EPILEPTICUS IN CHILDREN IN THE PEDIATRIC HOSPITAL AIN SHAMS UNIVERSITY

Abstract

SUMMARY N on-convulsive status epilepticus (NCSE) is a persistant ( >30 minutes) change in behaviour and or mental processes from baseline associated with continuous epileptiform EEG changes but without major motor signs. While there are no universally agreed upon diagnostic criteria and no pathognomonic EEG changes in NCSE, persistent abnormalities without convulsive activity are the “gold standard” of diagnosis. The aim of our study was to determine risk factors of nonconvulsive status epilepticus in children and classify patients of NCSE according to underlying etiology and symptoms. The study included 50 patients were diagnosed as NCSE based on the previous definition. All patients included in this study were subjected to full medical history, thorough clinical examination, EEG, laboratory investigations and neuroimaging (CT and MRI) according to indication. Results  Our study was conducted on 50 patients. 23 of them were females and 27 males. Their age range from 0.6 to 5 years, with mean age 3.15 ± 1.58 years and median 3 years. Patients less than one year were 10 patients.  Twenty two patients admitted in hospital, nine of them were admitted in ICU and 13 were admitted in ward. The causes of admission were fever and convulsions in seven patients, uncontrolled convulsions in ten patients and impaired conscious level in five patients.  Twenty seven patients with disturbed level of consciousness, 40 patients with abnormal behavior or disoriented, 34 patients with muscle twitches in extremities and face, 46 patients with abnormal ocular movements, 30 patients with tonic – clonic activity in current episode and 3 patients with signs of increased ICT.  Six patients with NCSE were normal before current illness and developed their first seizure activity, while five patients were cryptogenic epileptic cases, 36 known cases of CP with epilepsy and three known cases of IEM with epilepsy.  Fifty patients (100%) with NCSE had positive symptoms which included 40 patients with abnormal behavior, 34 patients with abnormal muscle twitches, 46 patients with abnormal ocular movement and 43 patients with negative symptoms all of them had decreased responsiveness and one patient with aphasia.