Piero Pavone*, Silvia Marino, Simona Domenica Marino, Raffaele Falsaperla
Pediatric Emergency Department, University Hospital “Policlinico-Vittorio Emanuele”, ItalyFulltext PDF
Febrile, afebrile seizures and status epilepticus in children are causes of frequent consultations in the Pediatric Emergency Department (PED). The Authors report on the assessment and treatment carried out in a single-center of the PED at the University Hospital of Catania over a three years period. Five thousand and forty-three children were admitted to the PED: Of these 994 were referred for seizures, 733 of febrile types and 261 with epileptic seizures. After a rapid and progressive procedure of assessment, the children were treated with anticonvulsants, typically Midazolam (Mz): No treatment was carried out in a group of children in whom the febrile seizures had already been remitted at the arrival. Following the administration of Mz, remission was obtained in 315 (87%) and in 241 (92%) of the patients with febrile seizures and epileptic seizures. In 47 (12.9%) of children with febrile status epilepticus and 20 (7.6%) with convulsive status epilepticus it was necessary to apply a second administration of Mz In 19 and 4 cases, respectively, in those children unresponsive to treatment, Mz was replaced by Levetiracetam. Six children were transferred to Intensive Care for further attempts at treatment. There are various treatment modalities in children affected by seizures and convulsive status epilepticus and there is no general agreement regarding the schedule and types of drug. In some cases, seizures in children may have a serious effects and it may represent a notable challenge for doctors attending the PED.
Childhood; Seizures; Treatment; Emergency
Pavone P, Marino S, Marino SD, Falsaperla R. Management of Childhood Seizure in Pediatric Emergency Department. Ann Epilepsy Seizure. 2018; 1(1): 1002.