Effect of treatment of convulsive status epilepticus on outcome in children

Convulsive Status Epilepticus (CSE) is most common neurological emergency in childhood. Condition has been defined as a convulsion lasting at least 30 min or recurrent convulsions occurring over a 30-min period without recovery of consciousness. It is generally accepted that early intervention for terminating seizures is beneficial for outcome. The aim of our study was to evaluate influences of pre-hospital and hospital treatment strategies on the outcome of CSE. Our prospective, hospital-based study was performed in Tbilisi and included 48 Patients with CSE, admitted to the emergency department of M. Iashvili Children's Central Hospital from March 2007 to March 2012. The cases were reviewed according to pre-hospital and hospital treatment strategies and outcome. "North Central London Epilepsy Network for Children & Young People" Guideline-"The Management of Convulsive Status Epilepticus" was adapted for the Georgian reality. Our study identified statistically significant increase of incidence of artificial ventilation in patients receiving more than one dose of BZD in pre hospital as in hospital setting; additionally we found a statistically strong relationship between timely initiation of treatment and appropriate pre-hospital treatment with a short duration of CSE. From our data the number of doses of benzodiazepine and a long period before admission are the main determinants of seizure prolongation. Lack of Standardized pre hospital treatment of pediatric CSE had statistically significant negative influence on outcome of CSE.