JOURNAL ARTICLE
MULTICENTER STUDY

Electrographic seizures after convulsive status epilepticus in children and young adults: a retrospective multicenter study

Iván Sánchez Fernández, Nicholas S Abend, Daniel H Arndt, Jessica L Carpenter, Kevin E Chapman, Karen M Cornett, Dennis J Dlugos, William B Gallentine, Christopher C Giza, Joshua L Goldstein, Cecil D Hahn, Jason T Lerner, Joyce H Matsumoto, Kristin McBain, Kendall B Nash, Eric Payne, Sarah M Sánchez, Korwyn Williams, Tobias Loddenkemper
Journal of Pediatrics 2014, 164 (2): 339-46.e1-2
24161223

OBJECTIVE: To describe the prevalence, characteristics, and predictors of electrographic seizures after convulsive status epilepticus (CSE).

STUDY DESIGN: This was a multicenter retrospective study in which we describe clinical and electroencephalographic (EEG) features of children (1 month to 21 years) with CSE who underwent continuous EEG monitoring.

RESULTS: Ninety-eight children (53 males) with CSE (median age of 5 years) underwent subsequent continuous EEG monitoring after CSE. Electrographic seizures (with or without clinical correlate) were identified in 32 subjects (33%). Eleven subjects (34.4%) had electrographic-only seizures, 17 subjects (53.1%) had electroclinical seizures, and 4 subjects (12.5%) had an unknown clinical correlate. Of the 32 subjects with electrographic seizures, 15 subjects (46.9%) had electrographic status epilepticus. Factors associated with the occurrence of electrographic seizures after CSE were a previous diagnosis of epilepsy (P = .029) and the presence of interictal epileptiform discharges (P < .0005). The median (p25-p75) duration of stay in the pediatric intensive care unit was longer for children with electrographic seizures than for children without electrographic seizures (9.5 [3-22.5] vs 2 [2-5] days, Wilcoxon test, Z = 3.916, P = .0001). Four children (4.1%) died before leaving the hospital, and we could not identify a relationship between death and the presence or absence of electrographic seizures.

CONCLUSIONS: After CSE, one-third of children who underwent EEG monitoring experienced electrographic seizures, and among these, one-third experienced entirely electrographic-only seizures. A previous diagnosis of epilepsy and the presence of interictal epileptiform discharges were risk factors for electrographic seizures.

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