Clinical and pharmacological approaches of status epilepticus in children: Personal experience. Minerva Psichiatrica

Background: Status epilepticus is a neurological emergency that require a prompt treatment following steps of more aggressive therapy. We analysed efficacy of treatment protocol in paediatric SE. Methods: We present a retrospective study in 29 patients (age range: 3mm-18yy) affected by status epilepticus (SE) of whom 16 patients had a previous diagnosis of epilepsy (symptomatic or idiopathic) while, in 13 cases, SE was the first epileptic event. Protocol of treatment suggests a first treatment with intravenous Diazepam followed by a bolus of Phenytoin (PHT) in case of non-response. All patients were carefully monitored, electroencephalographic activity (EEG) and vital signs, particularly respiratory depression. When the patients were classified as refractory or suffered from respiratory insufficiency, they were transferred into ICU where anesthetic drugs ( propofol or pentothal) could be administered. Results: Seventeen children were treated in neurological unit: 7 (24%) children responded to intravenous Diazepam. 10 (35%) children required an additional bolus of Phenytoin at the variable dose of 15-20 mg/Kg/bolus. 12 patients (41%) were admitted to Intensive Unit Care (ICU): 3 for respiratory insufficiency and 9 for treatment with anaesthetics drugs. Conclusions: In our experience so as in literature there is no Gold Standard in the treatment of SE. Nearly half of patients needed ICU support thus, the best approach still remains multidisciplinary.