PO-0312 Refractory Convulsive Status Epilepticus (rcse) In Children: Causes, Risk Factors And Outcome

<sec><st>Introduction</st> RCSE is a life-threatening neurologic emergency with high mortality and morbidity, in which seizures do not respond to first and second – line anticonvulsant drug therapy. The aim of this study was to determine the risk factors, and the impact on the outcome of RCSE in children. </sec> <sec><st>Patients and methods</st> In this prospective study we analyse 53 children with RCSE. Factors associated with seizure refractoriness were analysed using logistic regression. </sec> <sec><st>Results</st> Of 245 patients with convulsive status epilepticus, 53 developed RCSE (21.6%), 37 of whom were males (70%), with a mean age of 3 years (1 month–15 years). 11 patients (21%) had a history of epilepsy. The most frequent etiologies’ were acute symptomatic (73, 6%). Encephalitis 13 patients (24, 5%), meningitis 8 patients (15%), septic shock 5 patients (9, 4%), were the main acute etiologies. Acute symptomatic causes (odds ratio [OR] 9, 95% confidence interval [CI] 3.86–24.168; p < 1–4), duration of CSE ≥ 6 h (OR 5,8% [CI] 1.828–18.778; pp = 00034), complications (OR 13 [CI] 4.324–40.108; pp < 1–4) and received > 2 doses of benzodiazepines (OR 5 [CI] 1.133–25.425; pp = 0034) were identified as independent risk factors for RCSE. During hospitalisation 24 patients (45%) died (p < 1–4). On discharge from hospital, 14 patients (26.4%) presented new neurological deficit or difficult-to-manage epilepsy. RCSE was associated with prolonged hospital length of stay (> 3 days) (p < 1–4). </sec> <sec><st>Conclusion</st> GCSE termination and outcome seem clearly associated with adherence to treatment protocol, etiologies and duration of the CSE. </sec>