Prevalence and outcome of childhood status epilepticus in a tertiary hospital in the Coastal City of Calabar, Nigeria

Abstract

Background: Status epilepticus (SE) is the most common neurological emergency encountered in childhood. It is life threatening with risk of  neurological sequelae such as epilepsy and cognitive impairment. The outcomes are often determined by the cause. This study is aimed at highlighting the aetiology and outcome of SE with a view to drawing the attention of healthcare providers to the need for prompt management to prevent neurological sequelae.

Method: A retrospective study of all children admitted through the Children Emergency Unit of the University of Calabar Teaching Hospital between January and December 2019 with a diagnosis of SE. All children who had seizure lasting 30 minutes and above or serial convulsions without regaining consciousness in between episodes, were recruited into the study. The demographic characteristics and clinical parameters were documented. The treatment modalities and the outcomes were also documented. The data obtained was analysed using SPSS software version 23. Results were expressed in simple proportions and percentages.

Results: The prevalence of status epileptics was 3.03%. Viral encephalitis, cerebral malaria, epilepsy and meningitis were the major underlying  causes. Children with SE due to CNS infection were more likely to suffer neurological deficit or death. Children with seizures lasting longer than one hour had a relatively poorer outcome; delayed presentation to health facility also portends poor outcome.

Conclusion: CNS infections are the major cause of SE in Nigeria. Outcome is determined by the aetiology, duration of seizures and timeliness of intervention. Protection against infections and prompt initiation of appropriate treatment improves outcome.