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Severe Refractory Status Epilepticus Owing to Presumed Encephalitis

Child Development Center and Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, umkramer{at}netvision.net.il

Zamir Shorer, MD

Pediatric Neurology Units, Departments of Pediatrics, at: Soroka Medical Center, Beer-Seva

Bruria Ben-Zeev, MD

Sheba Medical Center, Ramat-Gan

Tally Lerman-Sagie, MD

Wolfson Medical Center, Holon

Hadassa Goldberg-Stern, MD

Schneider Medical Center, Petah-Tiqva

Eli Lahat, MD

Assaf Harofe Medical Center, Tzrifin, Israel

The severe refractory type of status epilepticus is very rare in the pediatric population. Eight children with the severe refractory type of status epilepticus owing to presumed encephalitis are described. The age at the onset of status epilepticus of the eight study children ranged between 2.5 and 15 years. Seven of the eight children presented with fever several days prior to the onset of seizures. A comprehensive clinical and laboratory investigation failed to delineate a cause for their seizures. Burst suppression coma was induced by pentothal, midazolam, propofol, or ketamine in all of the children. The mean duration of anesthesia was 28 days (range 4—62 days), but the seizures persisted in spite of repeated burst suppression cycles in all of them. Two children died. Four of the surviving children continued to suffer from seizures, and cognitive sequelae were present throughout follow-up in four children. In summary, the severe refractory type of status epilepticus of the acute symptomatic type owing to relatively mild encephalitis carries a high mortality rate and poor morbidity in terms of seizures and cognition at follow-up. ( J Child Neurol 2005;20:184—187).

Journal of Child Neurology, Vol. 20, No. 3, 184-187 (2005)
DOI: 10.1177/08830738050200030301


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