Reddy Y, et al. – Researchers planned this study to explain the clinical profile, aetiology, neuroimaging and electroencephalogram (EEG) findings as well as the outcome of children with convulsive status epilepticus (CSE) in Sub–Saharan Africa. The high burden of infection related CSE was correlated with high morbidity and mortality rates in contrast to the rates in developed countries. This underscored the need for early recognition and treatment of underlying conditions.

• The researchers conducted a retrospective analysis of electronic records of children with CSE admitted to the Paediatric Intensive Care Unit (PICU) over an 8-year period from January 2007 to December 2014.

• A total of 76 patients were admitted to the PICU with CSE and 55(72%) had refractory status epilepticus.
• At presentation, the median age was 15 months (IQR 6-37 months).
• Meningoencephalitis and gastroenteritis were the main aetiologies in 33(43%) and 19(25%) patients respectively.
• For CSE, the most frequently used antiepileptic drugs in PICU consisted of infusions of midazolam (96%) and thiopentone (22%).
• The researchers observed abnormal neuroimaging findings in 53(75%) patients with hypoxic changes in 17 patients.
• The predictors of poor outcome included the use of more than 3 antiepileptic drugs in PICU(RR-1.41(1.12-1.78), p = 0.003), duration of mechanical ventilation for more than 3 days (RR 1.98(1.22–3.20), p = 0.005) and abnormal neuroimaging findings (RR 3.21(1.53-6.72), p = 0.002) in multivariable regression.
• In this study, the mortality rate was 24%(n = 18).
• Persistent seizures or a new neurological deficit occurred in 58%(n = 44).
• CSE related diffuse cortical and brain stem injury was the main cause of mortality.
• Cerebral palsy and persistent epilepsy were predominant neurological sequelae.