Risk factors of status epilepticus in children - A literature review
DOI:
https://doi.org/10.12775/QS.2025.41.60314Keywords
status eplipeticus, children, risk factorsAbstract
Introduction: Status epilepticus is one of the most common and severe neurological emergencies in children. It is defined by prolonged or recurrent seizures without full recovery in between and is associated with significant morbidity and mortality. This study aims to identify predictors of SE development and poor prognosis in children.
Material and Methods: A focused literature search was conducted in PubMed for studies published between 2015 and 2025, targeting human research related to pediatric status epilepticus. Search terms included “status epilepticus”, “children” and “risk factors”. Relevant meta-analyses, observational studies, and clinical trials were reviewed and evaluated for methodological quality and clinical significance.
State of Knowledge: SE is a neurological emergency, where ongoing seizures lead to drug resistance and brain injury. Classification by seizure duration informs treatment urgency. Benzodiazepines, especially intramuscular midazolam, remain first-line, with levetiracetam as a common second-line option. While mortality is declining, outcomes depend on seizure length, cause, and care setting, underscoring the need for rapid intervention.
Discussion: This study identifies key clinical and laboratory factors influencing the development and outcomes of SE in children. Younger age, perinatal complications, neurodevelopmental delays, and prolonged or biphasic seizures were significantly linked to higher risk and poorer outcomes. Laboratory markers were also associated with worse prognosis. Infectious, autoimmune, and genetic etiologies emerged as important underlying causes of SE, underscoring the need for early identification and targeted interventions.
Conclusion: Early age, early-life complications, seizure duration, and metabolic imbalances are major indicators of poor prognosis in pediatric status epilepticus. Recognizing infectious, autoimmune, and genetic triggers is essential for timely and effective intervention.
References
[1] Khalil S. Husari, Katherine Labiner, Rong Huang, Rana R. Said: New-Onset Refractory Status Epilepticus in Children: Etiologies, Treatments, and Outcomes. Pediatric Critical Care Medicine 21(1): p 59-66, January 2020. doi: 10.1097/PCC.0000000000002108
[2] Claudia Riffo Allende: Actualización en estado epiléptico en niños definición, clasificación y tratamiento. Artículo especial - Revisión ISSN 1669-9106 MEDICINA (Buenos Aires) 2023: 83: 82-88
[3] Debopam Samanta, Lisa Garrity, Ravindra Arya: Refractory and Super-refractory Status Epilepticus. Indian Pediatr. 2020 Mar 15;57(3):239-253. doi: 10.1007/s13312-020-1759-0.
[4] Alejandra Vasqueza, Raquel Farias-Moellerb: Pediatric refractory and super-refractory status epilepticus. Seizure. 2019 May: 68:62-71. doi: 10.1016/j.seizure.2018.05.012. Epub 2018 May 19.
[5] Saba Jafarpour, Coral M Stredny, Juan Piantino, Kevin E Chapman: Baseline and outcome assessment in pediatric status epilepticus. Seizure. 2019 May: 68:52-61. doi: 10.1016/j.seizure.2018.04.019. Epub 2018 Apr 27
[6] Lindsey A Morgan, Jennifer B Hrachovec, Howard P Goodkin: Pediatric Status Epilepticus: Treat Early and Avoid Delays. Paediatr Drugs. 2023 Jul;25(4):411-424. doi: 10.1007/s40272-023-00570-1. Epub 2023 May 13.
[7] Zimmern, Vincent; Korff, Christian: Status Epilepticus in Children. Journal of Clinical Neurophysiology 37(5): p 429-433, September 2020. doi: 10.1097/WNP.0000000000000657
[8] Trinka E, Cock H, Hesdorffer D: A definition and classification of status epilepticus-report of the ILAE task force on classification of status epilepticus. Epilepsia 2015; 56:1515–23. Epub 2015 Sep 4. PMID: 26336950 doi: 10.1111/epi.13121
[9] Barzegar M, Mahdavi M, Behbehani AG, Tabrizi A: Refractory convulsive status epilepticus in children: etiology, associated risk factors and outcome. Iranian Journal Child Neurology 2015;9(4):24–31. PMID: 26664438 PMCID: PMC4670974
[10] Iván Sánchez Fernández, Michele C. Jackson, Nicholas S. Abend: Refractory status epilepticus in children with and without prior epilepsy or status epilepticus, BA, January 24, 2017, issue Neurology Journals 88 (4) 386-394, doi.org/10.1212/WNL.0000000000003550
[11] Yoshihiro Maegakia, Youichi Kurozawab, Akiko Tamasak: Early predictors of status epilepticus-associated mortality and morbidity in children. Brain & Development 37 (2015) 478–486. PMID: 25193404, doi: 10.1016/j.braindev.2014.08.004
[12] Reem A Alyoubi, Danah T Aljaafari, Mazen A Basheikh: The etiology and risk factors of convulsive status epilepticus in pediatric patients of tertiary center in Saudi Arabia. Neurosciences (Riyadh) 2021 Jan;26(1):26-30. doi: 10.17712/nsj.2021.1.20200116
[13] Eugen Trinka, Hannah Cock, Dale Hesdorffer, Andrea O Rossetti: A definition and classification of status epilepticus--Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015 Oct;56(10):1515-23. doi: 10.1111/epi.13121. Epub 2015 Sep 4
[14] Stefano Sartori, Margherita Nosadini, Giulio Tessarin: First-ever convulsive seizures in children presenting to the emergency department: risk factors for seizure recurrence and diagnosis of epilepsy. Dev Med Child Neurol. 2019 Jan;61(1):82-90. Epub 2018 Sep 7. doi: 10.1111/dmcn.14015.
[15] Daniel A Freedman, E Steve Roach: Status Epilepticus. Pediatr Rev. 2023 Jul 1;44(7):383-392. PMID: 37391637 doi: 10.1542/pir.2022-005632
[16] Lecio Figueira Pinto, João Paulo Santiago de Oliveira, Aston Marques Midon: Status epilepticus: review on diagnosis, monitoring, and treatment. Arq Neuropsiquiatr. 2022 May;80(5 Suppl 1):193-203. doi: 10.1590/0004-282X-ANP-2022-S113.
[17] Charles R Newton: Epidemiology of status epilepticus in children. Dev Med Child Neurol. 2021 Sep;63(9):1011. Epub 2021 May 27. doi: 10.1111/dmcn.14946.
[18] Matthew C. Walker: Pathophysiology of status epilepticus. Neuroscience Letters. Volume 667, 22 February 2018, Pages 84-91. doi: 10.1016/j.neulet.2016.12.044
[19] Reza Sharafi, Afagh Hassanzadeh Rad, Vahid Aminzadeh: Risk Factors of Febrile Status Epilepticus. Iranian Journal Child Neurology. 2019 Winter;13(1):57–63.
[20] Michele Ascoli, Edoardo Ferlazzo, Sara Gasparini, Giovanni Mastroianni, Rita Citraro: Epidemiology and Outcomes of Status Epilepticus. Internatioal Jouranl of General Medicine. Volume 14:2965-2973, 2021. PMID: 34234526 PMCID: PMC8254099 DOI: 10.2147/IJGM.S295855
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Copyright (c) 2025 Klaudia Mularczyk, Patrycja Znamirowska, Monika Paszkowska, Łukasz Karaban, Magdalena Kupis, Anna Jakubiak, Joanna Miśkiewicz, Michał Borawski, Aleksandra Ciuła, Tadeusz Kuźnieców
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