Risk factors and correlation with prognosis of epileptic seizures in 284 pediatric patients in pediatric intensive care unit with electroencephalography monitoring
10.3760/cma.j.cn101070-20230501-00352
- VernacularTitle:儿童重症监护病房284例脑电图监测儿童癫痫发作的危险因素及其与预后的相关性
- Author:
Qiao GUAN
1
;
Gang LIU
;
Tian SANG
;
Jun LIU
;
Yuwu JIANG
;
Suyun QIAN
Author Information
1. 国家儿童医学中心，首都医科大学附属北京儿童医院重症医学科，北京 100045
- Keywords:
Epileptic seizure;
Electroencephalogram;
Prognosis;
Pediatric intensive care unit
- From:
Chinese Journal of Applied Clinical Pediatrics
2023;38(9):702-706
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To illustrate the onset of epileptic seizures in children with brain injury admitted in pediatric intensive care unit (PICU), and to explore the risk factors and the correlation between epileptic seizures and the prognosis.Methods:Clinical data of pediatric patients with brain injury who were admitted to PICU of Peking University First Hospital from January 2013 to December 2019, and monitored by video electroencephalography (VEEG) were retrospectively collected, including general demographic information, etiological data, clinical seizures prior to VEEG performing, in-hospital mortality, brain function score, VEEG manifestations, etc.Seizures detected by VEEG were the primary outcome, and prognosis when discharged from PICU was the secondary outcome. Logistic regression was used to analyze the factors associated with seizures and poor outcome. Results:A total of 284 children were included, involving 54.9%(156/284) males.The median age of included children was 1.7(0.5, 5.0) years.Stratified by the cause of disease, 45.1%(128/284) had epilepsy, 26.1%(74/128) had genetic metabolic disease, and 14.4%(41/284) had central nervous system infection.A total of 82.0%(233/284) children had abnormal VEEG background activities, and 59.5%(169/284) had interictal epileptic discharges.Seizures were detected in 106 cases, including 39.6%(42/106) of non-convulsive seizures and 24.5%(26/106) of non-convulsive epileptic states.There were 12.0% (34/284) had poor prognosis at discharge, including 24 patients died in-hospital, and Pediatric Cerebral Performance Category scores were increased in 10 survivors.Multivariate Logistic regression analysis showed that seizures existed before VEEG monitoring and interictal epileptiform discharge were the independent risk factors for seizure.Besides, mental retardation, sepsis related encephalopathy, consciousness abnormality during VEEG, abnormal VEEG background activity, and epileptic status were significantly correlated with the poor prognosis of children with brain injury in PICU. Conclusions:The incidence of electrographic seizure is higher in children with brain injury in PICU, and VEEG monitoring is beneficial to children with brain injury that achieves an early identification of seizures and prediction of prognosis.
