Jafarpour S, et al. - Researchers here focussed on new-onset status epilepticus in pediatric patients regarding causes, characteristics, and outcomes. Findings revealed a risk of recurrent seizures, recurrent status epilepticus, death, and subsequent cognitive/behavioral impairment among these patients. They suggested a requirement of specific monitoring and care interventions in this high-risk population.

Methods

• Researchers performed a retrospective study to assess the clinical characteristics in patients aged 1 month to 21 years who presented during 6 consecutive years with convulsive status epilepticus and without a prior history of seizures. 
• In this study, New-Onset Refractory Status Epilepticus (NORSE) was defined as status epilepticus refractory to two lines of treatment, without an identified cause in the first 48 hours.

Results

• Researchers recognized 460 patients with status epilepticus.
• Seventy-nine (17.2%) of these presented with new-onset status epilepticus, including 4 (0.9%) with NORSE.
• The median age of the patients with NORSE was 3.5 years (IQR: 1.08-6.75) and 54.4% of them were female.
• Median seizure duration of 20 minutes (IQR: 10-40) was noticed.
• In this study, etiology was unknown in 36.7%, symptomatic in 30.3%, provoked in 16.5%, and provoked with an existing symptomatic etiology in 16.5%.
• In 70.9% of the patients, abnormal EEG was observed, while they noticed an abnormal MRI in 54.7%.
• They followed up the patients for a median duration of 63 months (IQR: 21-97).
• They noticed the mortality rate of 3.8%.
• Of 55 patients who were developmentally normal at baseline, a significant cognitive impairment was noticed in 29.1% at last follow-up, and 20% indicated academic difficulties or behavioral problems.
• Greater odds of having cognitive and behavioral problems were noticed among patients with symptomatic etiology compared to the unknown etiology (OR=3.83, p=0.012), while they observed no difference between the provoked and the unknown groups (OR=0.62, p=0.50).