January 22, 2018

Delayed Treatment Worsens Outcomes in Children with Status Epilepticus

Delayed first-line benzodiazepine treatment is independently associated with major adverse outcomes in children with status epilepticus (SE), according to a JAMA Neurology study. The results raise the question as to whether poor outcomes could, in part, be prevented by earlier administration of treatment.

Patients in the status epilepticus study were admitted with refractory convulsive SE to 11 pediatric tertiary hospitals in the United States and stratified into two groups — those who received timely first-line benzodiazepine (i.e., given within less than 10 minutes of seizure onset); and those who received treatment within 10 or more minutes.

The status epilepticus study associated an untimely treatment with a higher frequency of death, use of continuous infusions, longer convulsion duration, and more frequent hypotension. These findings may change the perception of acute seizure and status epilepticus treatment, tentatively converting it into an extremely time-sensitive emergency that is similar to stroke or other cardiovascular events.