Adverse outcomes following convulsive status epilepticus in children: Relationship with hippocampal injury

Convulsive status epilepticus (CSE) is the most common medical neurologic emergency in childhood. It is associated with significant mortality and morbidity. The estimates for the frequencies of adverse outcomes have a very wide range, but even the lower estimates are clinically important. The major predictor of outcomes following CSE is etiology. The characteristics of the episode of CSE itself, for example, seizure length and type, are relatively poor predictors. Nevertheless, there is a relationship between CSE and hippocampal injury. This relationship is well established in animal models, and there is some prospective evidence from human studies that CSE (particularly prolonged febrile seizure) can cause acute hippocampal abnormalities. Further study is required to establish the clinical relevance of these acute findings and to determine whether they predict later mesial temporal sclerosis associated with temporal lobe epilepsy.