Annals of Indian Academy of Neurology
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AIAN REVIEW
Year : 2020  |  Volume : 23  |  Issue : 6  |  Page : 747-754

Status epilepticus in neonates and infants


1 Paediatric Neurologist, BL Kapoor Hospital, New Delhi, India
2 Department of Neurology, Lady Hardinge Medical College, New Delhi, India
3 Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India

Correspondence Address:
Dr. Suvasini Sharma
Associate Professor, Department of Paediatrics (Neurology Division), Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi - 110 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.AIAN_189_20

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Status epilepticus (SE) is a common neurological emergency in childhood associated with high mortality and morbidity. Acute management of seizures along with aggressive evaluation for establishing the underlying cause are crucial determinants of outcome. Neonatal status epilepticus carries the burden of poor neurological outcomes and may lead to global developmental delay as well as persistent seizures. The aetiology and pathophysiological mechanisms of SE in neonates and young infants differ compared to older children and adults. The most common causes of SE in neonates includes hypoxic sequelae, ischemic stroke and intracranial haemorrhage. In infants, febrile status epilepticus and acute symptomatic seizures are more common than remote symptomatic causes. Recent advances in neuroimaging modalities and molecular diagnostic techniques have facilitated better diagnostic precision. There is deplorable lack of evidence evaluating management strategies of SE in this age group. In addition to prompt initiation of antiseizure medications, vitamin supplementation needs to be empirically added. Simultaneously, meticulous evaluation to determine cause must also be conducted. In this review, we discuss challenges and an algorithmic approach to the diagnosis and management of SE in neonates and infants.


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