Electrographic seizures in pediatric ICU patients: cohort study of risk factors and mortality.

Published

Journal Article

We aimed to determine the incidence of electrographic seizures in children in the pediatric intensive care unit who underwent EEG monitoring, risk factors for electrographic seizures, and whether electrographic seizures were associated with increased odds of mortality.Eleven sites in North America retrospectively reviewed a total of 550 consecutive children in pediatric intensive care units who underwent EEG monitoring. We collected data on demographics, diagnoses, clinical seizures, mental status at EEG onset, EEG background, interictal epileptiform discharges, electrographic seizures, intensive care unit length of stay, and in-hospital mortality.Electrographic seizures occurred in 162 of 550 subjects (30%), of which 61 subjects (38%) had electrographic status epilepticus. Electrographic seizures were exclusively subclinical in 59 of 162 subjects (36%). A multivariable logistic regression model showed that independent risk factors for electrographic seizures included younger age, clinical seizures prior to EEG monitoring, an abnormal initial EEG background, interictal epileptiform discharges, and a diagnosis of epilepsy. Subjects with electrographic status epilepticus had greater odds of in-hospital death, even after adjusting for EEG background and neurologic diagnosis category.Electrographic seizures are common among children in the pediatric intensive care unit, particularly those with specific risk factors. Electrographic status epilepticus occurs in more than one-third of children with electrographic seizures and is associated with higher in-hospital mortality.

Full Text

Cited Authors

  • Abend, NS; Arndt, DH; Carpenter, JL; Chapman, KE; Cornett, KM; Gallentine, WB; Giza, CC; Goldstein, JL; Hahn, CD; Lerner, JT; Loddenkemper, T; Matsumoto, JH; McBain, K; Nash, KB; Payne, E; Sánchez, SM; Fernández, IS; Shults, J; Williams, K; Yang, A; Dlugos, DJ

Published Date

  • July 2013

Published In

Volume / Issue

  • 81 / 4

Start / End Page

  • 383 - 391

PubMed ID

  • 23794680

Pubmed Central ID

  • 23794680

Electronic International Standard Serial Number (EISSN)

  • 1526-632X

International Standard Serial Number (ISSN)

  • 0028-3878

Digital Object Identifier (DOI)

  • 10.1212/WNL.0b013e31829c5cfe

Language

  • eng