Comparison of Clinical Outcomes and Treatment Methods Applying International Guideline in Status Epilepticus

Kim, Hwan Soo; Kim, Sung Koo; Hwang, Il Tae; Lee, Kon Hee

Abstract

PURPOSE: Status epilepticus(SE) is a common neurological emergency in childhood. SE is defined as a seizure or series of seizures without recovery of consciousness between seizures lasting at least 30 minutes. We investigated treatment modalities and clinical courses of patients with SE and tried to find out the differences between international standards.
METHODS
We reviewed the medical records of 36 cases of SE who visited our hospitals from January 2002 to December 2007. We analyzed age, duration of seizures before and after arrival at hospital, time taken for administration of antiepileptic drugs(AED) and compared them with APLS guideline(3rd edition).
RESULTS
There were 32 cases in which lorazepam was used as the first AED and the mean time needed for administration was 4.6+/-6.7minutes. Thirty cases needed a second dose of lorazepam and the mean time needed for administration was 10.2+/-8.2 minutes. Seven patients(21.1%) received inappropriate treatment at the first step and 25 patients(83.3%) and 21 patients(84.0%) at the second and the third step respectively. There were 15 cases in which phenytoin or phenobarbital was used as the second line AED and the mean time needed for administration was 25.8+/-61.8 minutes.
CONCLUSION
Early treatment of SE is important in reducing mortality and morbidity associated with SE. In this study we found that a large number of patients were not treated according to the international guideline. Further study is needed to understand the reasons for such differences.