Time to treatment in pediatric patients with repeated episodes of status epilepticus
Authors
Jennifer V. Gettings, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Iván Sánchez Fernández, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Anne Anderson, Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
J Nicholas Brenton, Departments of Neurology and Pediatrics, University of Virginia, Charlottesville, VA, USA.
Afra Can, Division of Child Neurology, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
Justice Clark, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Raquel Farias Moeller, Department of Neurology, Division of Pediatric Neurology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
Howard P. Goodkin, Departments of Neurology and Pediatrics, University of Virginia, Charlottesville, VA, USA.
Yi-Chen Lai, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Mohamad A. Mikati, Division of Pediatric Neurology, Duke University Medical Center, Duke University, Durham, NC, USA.
Lindsey A. Morgan, Division of Child Neurology, Department of Neurology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Edward Novotny, Division of Child Neurology, Department of Neurology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Adam P. Ostendorf, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
Juan Piantino, Division of Neurology, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, OR, USA.
James J. Riviello, Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Kumar Sannagowdara, Advocate Health - MidwestFollow
Robert C. Tasker, Division of Critical Care, Departments of Neurology, Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Dmitry Tchapyjnikov, Logan Health Children's Medical Center, Kallispell, MT, USA.
Mark S. Wainwright, Division of Child Neurology, Department of Neurology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
Angus Wilfong, Department of Child Health, University of Arizona College of Medicine and Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA.
Korwyn Williams, Department of Child Health, University of Arizona College of Medicine and Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA.
Bo Zhang, Department of Neurology, Boston Children's Hospital, Boston, Harvard Medical School, Boston, MA, USA.
Tobias Loddenkemper, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Marina Gaínza-Lein, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. m.gainzalein@gmail.com.
Recommended Citation
Gettings JV, Fernández IS, Anderson A, et al. Time to treatment in pediatric patients with repeated episodes of status epilepticus. BMC Neurol. 2025;25(1):221. Published 2025 May 26. doi:10.1186/s12883-025-04200-w
Abstract
Objective:To compare pediatric patients who presented with repeated status epilepticus episodes to patients with a single episode of status epilepticus and identify distinguishing clinical factors.
Methods:Retrospective analysis of a multicenter, prospective observational cohort of pediatric patients with status epilepticus between 2011 and 2019.
Results:Out of 504 status epilepticus episodes in 420 patients, 50 patients (10.3%) had repeated episodes of status epilepticus. The only predictor of repeated status epilepticus was a prior diagnosis of epilepsy. There was no difference in time to treatment with the first benzodiazepine in patients presenting with their first status epilepticus episode compared to their second status epilepticus episode [median 10 (interquartile range 5-30) vs. 14 (4.5-52.5) minutes; (p = 0.24)] or in time to treatment with the first non- benzodiazepine anti-seizure medication (ASM) [61 (37-125) vs. 71 (34.5-117.5) minutes; p = 0.61]. In patients with repeated status epilepticus episodes with onset outside the hospital, the percentage of patients treated by caregivers did not improve between the first and second status epilepticus episode (61% vs. 60%, p = 0.56). However, the time to first benzodiazepine was shorter in patients treated by caregivers compared to those who were not [5 (0-25) vs. 55 (41-120) minutes; p < 0.001].
Conclusions:Time to treatment with benzodiazepine and non-benzodiazepine ASM in patients with repeated episodes of status epilepticus does not improve for a second episode of status epilepticus, suggesting additional opportunities for intervention and teaching.
