Status epilepticus after the initial diagnosis of epilepsy in children

Anne T. Berg, Shlomo Shinnar, F. M. Testa, S. R. Levy, D. Frobish, S. N. Smith, B. Beckerman

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Objectives: To determine the risk and predictors of status epilepticus in children after they have been diagnosed with epilepsy. Methods: In a prospective community-based cohort study of 613 children, the occurrence of status epilepticus after the initial diagnosis of epilepsy was ascertained. Parents were called every 3 months, and interval medical records were reviewed every 6 months. Predictors of primary interest included a history of status before the diagnosis of epilepsy, age at onset, underlying etiology, and epilepsy syndrome. Data were analyzed with χ2 tests, Kaplan-Meier analyses, and Cox proportional hazards models. Results: Of 613 children followed a median of 8.0 years, 58 (9.5%) had >1 episode of status epilepticus during follow-up evaluation. The first episode occurred a median of 2.5 years after initial diagnosis (range, <1 month to 8.8 years). A history of previous status epilepticus was strong ly associated with subsequent status epilepticus (18/56 [32.1%] vs 40/557 [7.2%]; p < 0.0001). Younger age at onset and symptomatic etiology contributed independently to the risk of status epilepticus. Mortality was higher in children with status epilepticus before diagnosis, largely secondary to underlying cause. Conclusions: Status epilepticus occurs in -10% of children after initial diagnosis of epilepsy. Status epilepticus before initial diagnosis, young age at onset, and symptomatic etiology independently influence the risk of status epilepticus. In those without status epilepticus before diagnosis, the risk is modest and is realized over a prolonged period. For children at highest risk, maintaining abortive therapy in the home may be a reasonable precaution.

Original languageEnglish (US)
Pages (from-to)1027-1034
Number of pages8
JournalNeurology
Volume63
Issue number6
StatePublished - Sep 29 2004

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Status Epilepticus
Epilepsy
Age of Onset
Kaplan-Meier Estimate
Proportional Hazards Models
Medical Records
Cohort Studies
Parents

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Berg, A. T., Shinnar, S., Testa, F. M., Levy, S. R., Frobish, D., Smith, S. N., & Beckerman, B. (2004). Status epilepticus after the initial diagnosis of epilepsy in children. Neurology, 63(6), 1027-1034.

Status epilepticus after the initial diagnosis of epilepsy in children. / Berg, Anne T.; Shinnar, Shlomo; Testa, F. M.; Levy, S. R.; Frobish, D.; Smith, S. N.; Beckerman, B.

In: Neurology, Vol. 63, No. 6, 29.09.2004, p. 1027-1034.

Research output: Contribution to journalArticle

Berg, AT, Shinnar, S, Testa, FM, Levy, SR, Frobish, D, Smith, SN & Beckerman, B 2004, 'Status epilepticus after the initial diagnosis of epilepsy in children', Neurology, vol. 63, no. 6, pp. 1027-1034.
Berg AT, Shinnar S, Testa FM, Levy SR, Frobish D, Smith SN et al. Status epilepticus after the initial diagnosis of epilepsy in children. Neurology. 2004 Sep 29;63(6):1027-1034.
Berg, Anne T. ; Shinnar, Shlomo ; Testa, F. M. ; Levy, S. R. ; Frobish, D. ; Smith, S. N. ; Beckerman, B. / Status epilepticus after the initial diagnosis of epilepsy in children. In: Neurology. 2004 ; Vol. 63, No. 6. pp. 1027-1034.
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abstract = "Objectives: To determine the risk and predictors of status epilepticus in children after they have been diagnosed with epilepsy. Methods: In a prospective community-based cohort study of 613 children, the occurrence of status epilepticus after the initial diagnosis of epilepsy was ascertained. Parents were called every 3 months, and interval medical records were reviewed every 6 months. Predictors of primary interest included a history of status before the diagnosis of epilepsy, age at onset, underlying etiology, and epilepsy syndrome. Data were analyzed with χ2 tests, Kaplan-Meier analyses, and Cox proportional hazards models. Results: Of 613 children followed a median of 8.0 years, 58 (9.5{\%}) had >1 episode of status epilepticus during follow-up evaluation. The first episode occurred a median of 2.5 years after initial diagnosis (range, <1 month to 8.8 years). A history of previous status epilepticus was strong ly associated with subsequent status epilepticus (18/56 [32.1{\%}] vs 40/557 [7.2{\%}]; p < 0.0001). Younger age at onset and symptomatic etiology contributed independently to the risk of status epilepticus. Mortality was higher in children with status epilepticus before diagnosis, largely secondary to underlying cause. Conclusions: Status epilepticus occurs in -10{\%} of children after initial diagnosis of epilepsy. Status epilepticus before initial diagnosis, young age at onset, and symptomatic etiology independently influence the risk of status epilepticus. In those without status epilepticus before diagnosis, the risk is modest and is realized over a prolonged period. For children at highest risk, maintaining abortive therapy in the home may be a reasonable precaution.",
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AU - Testa, F. M.

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AU - Smith, S. N.

AU - Beckerman, B.

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N2 - Objectives: To determine the risk and predictors of status epilepticus in children after they have been diagnosed with epilepsy. Methods: In a prospective community-based cohort study of 613 children, the occurrence of status epilepticus after the initial diagnosis of epilepsy was ascertained. Parents were called every 3 months, and interval medical records were reviewed every 6 months. Predictors of primary interest included a history of status before the diagnosis of epilepsy, age at onset, underlying etiology, and epilepsy syndrome. Data were analyzed with χ2 tests, Kaplan-Meier analyses, and Cox proportional hazards models. Results: Of 613 children followed a median of 8.0 years, 58 (9.5%) had >1 episode of status epilepticus during follow-up evaluation. The first episode occurred a median of 2.5 years after initial diagnosis (range, <1 month to 8.8 years). A history of previous status epilepticus was strong ly associated with subsequent status epilepticus (18/56 [32.1%] vs 40/557 [7.2%]; p < 0.0001). Younger age at onset and symptomatic etiology contributed independently to the risk of status epilepticus. Mortality was higher in children with status epilepticus before diagnosis, largely secondary to underlying cause. Conclusions: Status epilepticus occurs in -10% of children after initial diagnosis of epilepsy. Status epilepticus before initial diagnosis, young age at onset, and symptomatic etiology independently influence the risk of status epilepticus. In those without status epilepticus before diagnosis, the risk is modest and is realized over a prolonged period. For children at highest risk, maintaining abortive therapy in the home may be a reasonable precaution.

AB - Objectives: To determine the risk and predictors of status epilepticus in children after they have been diagnosed with epilepsy. Methods: In a prospective community-based cohort study of 613 children, the occurrence of status epilepticus after the initial diagnosis of epilepsy was ascertained. Parents were called every 3 months, and interval medical records were reviewed every 6 months. Predictors of primary interest included a history of status before the diagnosis of epilepsy, age at onset, underlying etiology, and epilepsy syndrome. Data were analyzed with χ2 tests, Kaplan-Meier analyses, and Cox proportional hazards models. Results: Of 613 children followed a median of 8.0 years, 58 (9.5%) had >1 episode of status epilepticus during follow-up evaluation. The first episode occurred a median of 2.5 years after initial diagnosis (range, <1 month to 8.8 years). A history of previous status epilepticus was strong ly associated with subsequent status epilepticus (18/56 [32.1%] vs 40/557 [7.2%]; p < 0.0001). Younger age at onset and symptomatic etiology contributed independently to the risk of status epilepticus. Mortality was higher in children with status epilepticus before diagnosis, largely secondary to underlying cause. Conclusions: Status epilepticus occurs in -10% of children after initial diagnosis of epilepsy. Status epilepticus before initial diagnosis, young age at onset, and symptomatic etiology independently influence the risk of status epilepticus. In those without status epilepticus before diagnosis, the risk is modest and is realized over a prolonged period. For children at highest risk, maintaining abortive therapy in the home may be a reasonable precaution.

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