Document Detail


Nonconvulsive seizures in the pediatric intensive care unit: etiology, EEG, and brain imaging findings.
MedLine Citation:
PMID:  16981868     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSES: To determine the occurrence of nonconvulsive seizures (NCS) in the Pediatric Intensive Care Unit (PICU); to ascertain the relationship of NCS to past medical history, etiology, EEG, and brain imaging; and to determine the concordance between abnormal EEG findings and neuroimaging abnormalities. METHODS: A retrospective review was conducted of all pediatric patients who were admitted or transferred to the PICU from January 2000 to December 2003 with an unexplained decrease in level of consciousness, no overt clinical seizures, and EEG recordings performed within the 24 h of onset of an altered state of consciousness. RESULTS: Twenty-three of 141 patients who met criteria for inclusion in the study (16.3%) were found to have NCS. The male to female ratio was 1.9:1. The largest group of patients (43%) had no preexisting neurological condition prior to the onset of NCS. In the remainder, the etiology of NCS included: acute structural brain lesion (48%), acute nonstructural brain lesion (22%), epilepsy-related seizure (13%), and others (17%). Epileptic foci were lateralized to the right side in 39.2%, the left side in 30.4%, and were bilateral in 30.4%. Of 23 patients with NCS, 18 (78.3%) demonstrated abnormal neuroimaging. In 10 of 18 of these patients (55.6%), the findings on neuroimaging were concordant with the lateralization found on EEG (p < 0.05, Fisher's exact test). CONCLUSIONS: NCS are not uncommon in pediatric patients with an altered state of consciousness. Almost half of the patients were previously healthy especially if they were under 6 months of age. This report highlights the importance of clinical awareness of NCS in the PICU.
Authors:
Montri Saengpattrachai; Rohit Sharma; Amrita Hunjan; Manohar Shroff; Ayako Ochi; Hiroshi Otsubo; Miguel A Cortez; O Carter Snead
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  47     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-19     Completed Date:  2006-10-20     Revised Date:  2010-06-18    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1510-8     Citation Subset:  IM    
Affiliation:
Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Brain / pathology*
Electroencephalography / statistics & numerical data*
Female
Functional Laterality
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric*
Magnetic Resonance Imaging
Male
Retrospective Studies
Status Epilepticus / diagnosis*,  pathology*
Tomography, X-Ray Computed
Unconsciousness / diagnosis,  pathology
Comments/Corrections
Comment In:
Epilepsy Curr. 2007 May-Jun;7(3):70-2   [PMID:  17520078 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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