G97 Seizure duration with and without rescue medication in a European survey of children who experience prolonged acute convulsive seizures. (27th April 2016)

• Record Type: Journal Article
• Authors: Kirkham, F; Vigevano, F; Wilken, B; Raspall-Chaure, M; Grebla, R; Roskell, N; Werner-Kiechle, T; Lagae, L
• Is Part Of: Archives of disease in childhood. Volume 101(2016)Supplement 1
• Page Start: A56
• Page End: A57
• Publication Date: 2016-04-27
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2016-310863.94
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: To investigate the effect of rescue medication on seizure duration in children with epilepsy who have prolonged acute convulsive seizures (PACS). Methods: Practices in Emergency and Rescue medication For Epilepsy managed with Community-administered Therapy 3 (PERFECT-3) was a cross-sectional study in Germany, Italy, Spain and the UK. Eligible patients were non-institutionalised children aged 3–16 years who had been diagnosed with epilepsy ≥ 12 months previously, had experienced ≥ 1 PACS within the last 12 months and had currently prescribed rescue medication (s) for PACS. Investigators provided clinical assessments and parents/guardians completed web-based questionnaires. Parents were asked how long a prolonged seizure experienced by their child lasts on average without rescue medication and after rescue medication has been given; seizure start-point and end-point were not defined and no measurements were requested. Statistical tests were post hoc; p values are descriptive, non-inferential and uncorrected for multiple comparisons. Results: At baseline, most of the 286 enrolled patients had prescriptions for diazepam (69.2%) or midazolam (55.9%), and some had two (26.6%) or three (2.4%) prescribed rescue medications. According to parents (n = 258), the average length of children's prolonged seizures without rescue medication was 0 to < 5 min in 35.7% of patients, 5 to < 20 min in 42.6% and ≥ 20 min in 21.7%. When rescue medication was given, parents reported that seizures lasted 0 to < 5 min in 69.4% of patients, 5 to < 20 min in 25.6% and ≥ 20 min in 5.0%. Rescue medication was significantly associated with shorter seizures lasting < 5 min, compared with seizures lasting ≥ 5 min (X² = 58.8; p < 0.0001). Conclusion: In this parent-reported survey of children with epilepsy who had ≥ 1 PACS in the previous year, fewer children experienced seizures lasting ≥ 20 min when rescue medication was given, compared with when it was not given. Most children's seizures lasted ≥ 5 min without rescue medication, but most children experienced seizures lasting < 5 min when rescue medication was given, suggesting a reduced risk of developing status epilepticus.