Abstract

CHINGWALI-NSANTA, S; BUYS, H; BURMAN, R J  and  WILMSHURST, J M. Demographic and aetiological factors of paediatric status epilepticus: A South African retrospective observational study. S. Afr. j. child health [online]. 2024, vol.18, n.1, pp.46-52. ISSN 1999-7671.  http://dx.doi.org/10.7196/SAJCH.2024.v18i1.2019.

BACKGROUND. Status epilepticus (SE) is a common medical neurological emergency in childhood, and it is often serious and life-threatening. There is a paucity of data on the aetiology and demographics of affected children in resource-limited countries. OBJECTIVE. To understand the demographics and describe common causes of convulsive SE (CSE) in our local paediatric population. METHODS. We conducted a retrospective review of the demographics, clinical features, and characterisation of CSE of children who presented to the emergency department at Red Cross War Memorial Children's Hospital, in Cape Town, South Africa, between 2016 and 2018. RESULTS. More than half (n=63; 53%) of the 119 children were male. The median (interquartile range) age was 29.6 (14.8 - 76.1) months: 22 (18%) were <12 months; 63 (53%) were 1 - 5 years; and 34 (29%) were >5 years. Thirty-one (26%) were moderately to severely underweight-for-age and 5 (4%) were HIV-infected. In seizure semiology, 82 (71%) had generalised convulsive seizures and 34 (29%) had focal seizures. Based on International League Against Epilepsy-classified aetiology, 74 (62%) were secondary to acute infective cause, 12 (10%) were classified as electroclinical syndrome, 9 (8%) were remote and 25 (22%) had unknown aetiology. A recorded tympanic membrane temperature of >38 °C was found in 49 (44%) of 112 children and 36 were below the age of 5 years, supporting the diagnosis of febrile SE in these children. Fifty children (42%) were known with epilepsy-related breakthrough seizures. Imaging was abnormal in 24 (42%) of 57 children. Cerebrospinal fluid findings were abnormal in 7 (12%) of 57 children. Most children (n=87; 75%) were stabilised adequately for admission to the short-stay ward, however, eight required admission to the intensive care unit. No deaths were recorded in the cohort. CONCLUSION. Concordant with other studies, acute infections were the most common cause of SE in our setting.

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