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      Childhood convulsive status epilepticus: epidemiology, management and outcome.

      1 , ,

      Acta neurologica Scandinavica

      Wiley

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          Abstract

          Convulsive status epilepticus (CSE) in childhood is a medical emergency and its aetiology and outcome mean that it should be studied separately from adult CSE. The incidence in developed countries is between 17 and 23/100,000 with a higher incidence in younger children. Febrile CSE is the commonest single group with a good prognosis in sharp distinction to CSE related to central nervous system infections which have a high mortality. The aim of treatment is to intervene at 5 min and studies indicate that intravenous (i.v.) lorazepam may be a better first-line treatment than rectal diazepam and i.v. phenytoin a better second-line treatment than rectal paraldehyde. An epidemiological study strongly supports the development of prehospital treatment with buccal midazolam becoming a widely used but unlicensed option in the community. More than two doses of benzodiazepines increase the rate of respiratory depression without obvious benefit. The 1 year recurrence rate is 17% and the hospital mortality is about 3%.

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          Author and article information

          Journal
          Acta Neurol. Scand.
          Acta neurologica Scandinavica
          Wiley
          1600-0404
          0001-6314
          Apr 2007
          : 115
          : 4 Suppl
          Affiliations
          [1 ] Neurosciences Unit, University College, Institute of Child Health, and Great Ormond Street Hospital for Children, NHS Trust, London, UK. b.neville@ich.ucl.ac.uk
          Article
          ANE805
          10.1111/j.1600-0404.2007.00805.x
          17362272

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