期刊
NEUROLOGY
卷 81, 期 4, 页码 383-391出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e31829c5cfe
关键词
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资金
- NIH [K23NS076550]
- Children's Hospital of Philadelphia, Department of Pediatrics
- NINDS/NIH
- University of California
- Thrasher Research Foundation
- Today's and Tomorrow's Children Fund
- Child Neurology Foundation/Winokur Family Foundation
- Canadian Institutes of Health Research
- SickKids Foundation
- PSI Foundation
- National Institutes of Health/NINDS
- Harvard Medical School and Boston Children's Hospital
- Program for Quality and Safety at Boston Children's Hospital
- Payer Provider Quality Initiative
- Epilepsy Foundation of America [EF-213583, EF-213882]
- Center for Integration of Medicine and Innovative Technology
- Epilepsy Therapy Project
- Pediatric Epilepsy Research Foundation
- Lundbeck
- Eisai
- Alberta Innovates Health Solutions
- Canadian League Against Epilepsy
- Fundacion Alfonso Martin Escudero
- NIH grants [1R01NS053998, 2U01NS045911, 1R01LM011124, U01NS077276]
Objectives: We aimed to determine the incidence of electrographic seizures in children in the pediatric intensive care unit who underwent EEG monitoring, risk factors for electrographic seizures, and whether electrographic seizures were associated with increased odds of mortality. Methods: Eleven sites in North America retrospectively reviewed a total of 550 consecutive children in pediatric intensive care units who underwent EEG monitoring. We collected data on demographics, diagnoses, clinical seizures, mental status at EEG onset, EEG background, interictal epileptiform discharges, electrographic seizures, intensive care unit length of stay, and in-hospital mortality. Results: Electrographic seizures occurred in 162 of 550 subjects (30%), of which 61 subjects (38%) had electrographic status epilepticus. Electrographic seizures were exclusively subclinical in 59 of 162 subjects (36%). A multivariable logistic regression model showed that independent risk factors for electrographic seizures included younger age, clinical seizures prior to EEG monitoring, an abnormal initial EEG background, interictal epileptiform discharges, and a diagnosis of epilepsy. Subjects with electrographic status epilepticus had greater odds of in-hospital death, even after adjusting for EEG background and neurologic diagnosis category. Conclusions: Electrographic seizures are common among children in the pediatric intensive care unit, particularly those with specific risk factors. Electrographic status epilepticus occurs in more than one-third of children with electrographic seizures and is associated with higher in-hospital mortality.
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