| Clinical significance of cerebrospinal fluid pleocytosis in pediatric refractory status epilepticus |
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Jung Mi Kim, Young Mi Kim, Soon Hak Kwon |
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Departments of Pediatrics, College of Medicine, Kyungpook National University, Daegu, Korea |
| 소아 난치성 간질 중첩증에서 뇌척수액 백혈구 증가증의 임상적 의의 |
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김정미, 김영미, 권순학 |
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경북대학교 의과대학 소아과학교실 |
Correspondence:
Soon Hak Kwon, Email: shkwon@knu.ac.kr
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| Abstract |
Purpose
: Refractory status epilepticus(RSE) is a serious neurological emergency in children. The mortality is high and the neurological outcome is not good. This study aimed to evaluate the clinical significance of cerebrospinal fluid(CSF) pleocytosis in refractory status epilepticus in children.
Methods
: From January 1999 to January 2006, 25 out of 37 children with refractory status epilepticus had spinal tapping. We retrospectively analyzed the data from these children's medical records. We compared the results between groups with and without CSF pleocytosis, and between a group with first seizure and a group with epilepsy .
Result : Six out of 25 children had CSF pleocytosis. The group without CSF pleocytosis had a higher mortality rate and required higher doses of antiepileptic drugs as compared with the group with CSF pleocytosis. The group with CSF pleocytosis had much worse neurologic segualae. However, except for the children with CNS infection, the overall prognosis between the group with and without CSF pleocytosis was not significantly different. All children with CSF pleocytosis came in with first seizures.
Conclusion
: In children with RSE, a CSF study must be perfomed as soon as possible to exclude the possibility of CNS infection. A CSF study is even more important in cases of first seizure or CNS infection suspected. Mild CSF pleocytosis without evidence of infection does not seem to affect the prognosis, so physicians should therefore be more cautious in selecting antibacterial or antiviral agents for it. |
| Key Words:
Refractory status epilepticus , Children , CSF pleocytosis , Prognosis , Mortality |
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