The consequences of convulsive status epilepticus in children.
Doctoral thesis, UCL (University College London).
Convulsive status epilepticus (CSE) is the most common neurological emergency in childhood. Approximately half of new CSE cases occur in children with no perceptible neurological priors (Chin et al., 2006). Prolonged febrile seizures (PFS), a type of CSE that occurs in neurologically normal children, have been retrospectively linked to temporal lobe epilepsy with hippocampal sclerosis. Imaging studies have revealed hippocampal abnormalities soon after PFS, yet, no neuropsychological study to date has investigated these children close to the time of insult. The present thesis investigated the effects of CSE on child development within a month of the incident and, subsequently, a year onwards. The first aim of this thesis was to investigate the effects of CSE on developmental functions using standardized assessments. The second aim was to examine children with PFS for signs of hippocampal dysfunction close to the time of incident. We hypothesized that aetiology would largely influence outcome in our CSE cohort, and, that children with PFS would reveal deficits in a delayed recognition paradigm that is thought to tap onto hippocampal processes. Eighty children were seen a mean of 38 days following CSE (34 PFS) and 50 children (24 PFS) were re-assessed a year onwards. At baseline neuropsychological impairments were evident in children following CSE associated with a PFS, as well as, children following CSE associated with other aetiologies (non-PFS), albeit, these were more pronounced in the non-PFS group. Moreover, in line with our hypothesis, the PFS group revealed deficits in a task of incidental recognition memory alluding to the presence of hippocampal dysfunction in this group. A year onwards deficits were still apparent in the two patient groups, although, the PFS group had shown some improvement on a number of measures. The implications of these findings for our understanding of CSE are discussed in this thesis.
|Title:||The consequences of convulsive status epilepticus in children|
|Open access status:||An open access version is available from UCL Discovery|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Child Health > Department of Neurosciences and Mental Health > ICH - Developmental Cognitive Neuroscience Unit|
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