| A Clinical Study of Acute Symptomatic Seizures in Children |
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Kyeong Eun Lee, Won Seop Kim |
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Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea |
| 소아에서 발생한 급성 증후성 경련의 임상적 고찰 |
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이경은, 김원섭 |
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충북대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: To determine the incidence, etiology, sex, age, seizure type and prognosis of acute
symptomatic seizures in children and evaluate the hypothesis that acute symptomatic status epilepticus(
SE) is associated with an increased risk of subsequent unprovoked seizure compared with
the risk of acute symptomatic seizure without SE.
Methods
: Five hundred and sixty-eight convulsive children visited the Pediatric Department of
Chungbuk National University Hospital from February 1991 to February 1999. Of these, 109 patients
were determined as acute symptomatic seizure, and their medical record were reviewed.
Results
: One hundred and nine children(59#boys, 50#girls) had acute symptomatic seizures, the
ratio of male to female and the ages at the onset of first seizure were 1.18 : 1 and 1.58¡¾2.53
years, respectively. Causes of acute symptomatic seizure in order of frequency were acute
gastroenteritis(33.0%), encephalopathy(31.2%), metabolic/toxic disturbance(19.3%), CNS infection
(11.0%), brain trauma(2.8%), cerebrovascular disease(1.8%) and CNS tumor(0.9%). At six months
of follow-up, the incidence of a first unprovoked seizure was 28.4% for children with acute
symptomatic seizure, 67.6% for those with encephalopathic cause, 44% for those with structural
cause, and 0% for those with metabolic cause. At six months of follow-up, the risk of a first
unprovoked seizure was significantly greater for those with acute symptomatic seizure with
SE(100%) than without SE(22%).
Conclusion
: The leading causes of acute symptomatic seizures were acute gastroenteritis. Agespecific
incidence was highest in the group aged 0-12 months. The incidence of subsequent unprovoked
seizure was highest in the group of encephalopathy. The risk for subsequent unprovoked
seizure was greater for those with SE than for those without SE and for those with
abnormal EEG and abnormal findings of neuroimage. |
| Key Words:
Acute symptomatic seizure, Status epilepticus |
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