Estado de mal convulsivo na urgência pediátrica: Estudo retrospectivo de cinco anos

Abstract

Background/Aims: status epilepticus (SE) is the most common neurological emergency in childhood. It may be associated with high mortality and morbidity, resulting in focal neurologic deficits, developmental disorder and epilepsy. The aims of this study were to describe the epidemiology, mortality and morbidity of convulsive SE and to assess the predictive factors of its neurological, cognitive and behavioral prognosis. Material and Methods: observational, retrospective, analytical study. Clinical files of children admitted to the Pediatric Emergency Department of Hospital Garcia de Orta with a diagnosis of convulsive SE between first January 2002 to 31st December 2006 were analyzed. The studied variables were age at crisis and current age, gender, type of seizure, duration and etiology of seizure, neurological deficit, epilepsy, seizures, psychomotor development and behavior. Regarding the last five variables data from before and after the SE were analyzed. Data analysis was performed with the programs Excel2007® and SPSS® 15.0. Results: 29 children were admitted with 33 episodes of SE aged between nine months and five years, there were no differences in gender distribution (male 12, female: 17 - p = 0.46). The etiology of SE was febrile in 16 children, remote symptomatic in seven related to idiopathic / cryptogenic epilepsy in five children and not classifiable in one case. The mean follow-up was six years and four months. There were no deaths associated with SE. There was deterioration in neurological status in two children (8.7%). Epilepsy was diagnosed following the SE in three (13%) children. Conclusions: This retrospective review suggests that the SE is associated with a better prognosis than that recorded a few decades ago. A more favorable prognosis was verified in febrile status than in other etiologies. © Ordem dos Médicos 2012.