Management of refractory convulsive status epilepticus varies at different medical centers

The management of refractory convulsive status epilepticus (RCSE) varies at different medical centers and from patient to patient. Rapid success in aborting these non-stop seizures is crucial as the risk of neurological damage is high and, though rare, may result in death depending on seizure duration. By pooling data and analyzing current RCSE management practices, researchers representing a multicenter network of tertiary referral hospitals in the U.S. conducted a study that could lead to improved treatment outcomes for potentially life-threatening seizures.

The network of hospitals [The Pediatric Status Epilepticus Research Group (pSERG)] sought to describe the care of children with RCSE, looking closely at the type of medications prescribed, order of administration, and the duration between seizure onset and drug administration.

In a report presented today at the American Epilepsy Society's 67th Annual Meeting, pSERG investigators analyzed 74 RCSE episodes in 72 children. The mean patient age for refractory seizures was 2.5 years (range 1-7 yrs.). Most RCSE episodes (56) began outside of the hospital and more than half of those (33) occurred in children without prior history of seizures (Platform B.02 / Abstract 1748180 - Management of Pediatric Refractory Convulsive Status Epilepticus in Clinical Practice).

"Our study suggests prominent variability in current anticonvulsant drug (AED) choices in a network of leading reference hospitals in the United States," said Tobias Loddenkemper, M.D., of Boston Children's Hospital and Harvard Medical School, who presented the report. "Escalation of one type of anticonvulsant to the next and, especially, the timing of drug administration left room for improvement. Our data provide a framework to do better in the care of pediatric patients with convulsive status epilepticus and highlight opportunities to be more aggressive and effective."

The group expects to conduct future collaborations that may allow for the collection of biologic samples to determine genetic factors and provide information for future interventional trials.