ICNC Abstracts, ICNC 2018

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Prolonged Seizures in Children
Clodagh Mitchell, Jay Shetty, Libby Dickson, Celia Brand, Paul Leonard, Ailsa McLellan

Last modified: 2018-09-14

Abstract


Background

Prolonged seizures (PS) in children carry significant risk of morbidity and mortality.1,2 Previous work has predominantly focused on status epilepticus ≥30min but a new ILAE definition has been produced following evidence that seizures ≥5min are associated with negative outcomes.3 There has been increasing effort by clinicians and epilepsy specialist nurses to manage PS effectively through benzodiazepines, education and training.4 This study aims to provide population-based data on children presenting with PS and their outcomes.

Methods

All children presenting to accident and emergency (A+E) between 2011-2017 from a Scottish Children’s hospital were identified (capture-recapture method with multiple datasets). Data was collated from electronic health records; including patient demographics, clinical characteristics, acute seizure management and outcomes. This data can be used to study long-term outcomes, including educational outcome, through national data linkage systems.

Results

There were 666 children (1234 seizure episodes). These accounted for 0.38% (95% CI (0.34-0.42%)) of A+E admissions. Age (figure 1), seizure duration (figure 2) and select patient demographics are displayed (table 1). PS incidence increased at the extremes of socioeconomic status and relationship with distance from A+E can be determined. Seizure duration, mortality and requirement for ventilatory support decreased compared to historical data. There was a lower likelihood of hospital admission where buccal midazolam was administered.

 

Conclusions

Adverse outcomes have decreased and the use of buccal midazolam is promising. Identifying high-risk groups provides opportunity for early intervention. This data forms the basis for extensive evaluation of acute seizure management and monitoring long-term outcomes.

 


Keywords


Epilepsy; Prolonged Seizures; Buccal Midazolam

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