Electroclinical Profile of Children with Electrical Status Epilepticus: Insights from a Tertiary Care Centre

Abstract

ABSTRACT

Objective: This study aims to explore the clinical and electroencephalographic (EEG) characteristics, treatment strategies, and associated comorbidities in children diagnosed with electrical status epilepticus (ESE) at a tertiary care center in Pakistan.

Study Design: Retrospective Chart Review study.

Place and Duration of Study: Paediatric Neurology Department, The Children’s Hospital & The ICH, Multan, from January 2020 to December 2024.

Materials and Methods: Medical records of 127 children diagnosed with ESE were retrospectively reviewed. Data were collected on seizure types, developmental history, family history of epilepsy, EEG findings, and anti-epileptic drug (AED) regimens.

Results: The majority of patients were male (66.9%, n=85), with a mean age of 6.9 years. Generalized tonic-clonic seizures were the most common type (48.8%, n=62), followed by focal tonic-clonic (12.6%, n=16) and myoclonic seizures (9.4%, n=12). Over half (54.3%) experienced daily seizures, with an average diagnostic delay of 4.8 years. Developmental delays were prevalent (67.7%, n=86), and regression was noted in 8.7% (n=11). EEG confirmed ESE in all cases, with generalized ESE (84.3%, n=107), focal ESE (10.2%, n=13), and multifocal ESE (5.5%, n=7). The leading causes were epilepsy (41.7%), developmental and epileptic encephalopathy (28.3%), and cerebral palsy with epilepsy (13.4%). Other contributing factors included metabolic disorders, brain malformations, and rare syndromes. Sodium Valproate was the most frequently prescribed AED (17.3%, n=22), though polytherapy was required in 74.8% of cases.

Conclusion: Paediatric ESE presents with diverse clinical features and significant neurodevelopmental challenges. Early EEG assessment and tailored management strategies are crucial for improving patient outcomes.

Keywords: Electrical status epilepticus, paediatric epilepsy, EEG abnormalities, neurodevelopmental delay.