Commentary
Video
Initiating Conversations on Recognition and Identification of Status Epilepticus in Lennox-Gastaut Syndrome: Babitha Haridas, MD, MBBS
Author(s):
The pediatric epileptologist at Johns Hopkins Medicine discussed common triggers and potential preventive measures of status epilepticus in LGS, as well as the importance of involving families and caregivers. [WATCH TIME: 4 minutes]
WATCH TIME: 4 minutes
"If we are aware of triggers like infections or medication changes, we can act quickly to prevent status epilepticus and improve outcomes."
Lennox-Gastaut syndrome (LGS) is a severe form of childhood-onset epilepsy characterized by multiple seizure types, cognitive and behavioral impairment, and distinctive electroencephalogram (EEG) abnormalities. To gain better insights on the management of status epilepticus (SE) in this patient population, a group of investigators performed a retrospective, cross-sectional study using prospective data from the pediatric Status Epilepticus Research Group (pSERG), a consortium of 21 tertiary pediatric hospitals in the United States and Canada.
Presented at the 2024 American Epilepsy Society (AES) Annual Meeting, held December 6-10, in Los Angeles, California, the database featured 845 patients, 51 of whom had a diagnosis of LGS or a history of developmental delays with tonic seizures. Of these, the most common etiology of SE was systemic infection (33%; n = 17), change in medication regimen (13%; n = 7), and unknown (19%; n = 10). Twelve out of 51 patients had continuous seizure activity, while 39 (76%) had intermittent seizures without returning to baseline. Of the 51 patients, 50 (98%) received a benzodiazepine as a first-line abortive agent, with subsequent doses administered to 32 (64%), 18 (56%), 10, 5, and 2 patients, respectively.
Lead investigator Babitha Haridas, MD, MBBS, sat down with NeurologyLive® during the meeting to discuss the implications of the study, highlighting the inherent unpredictability of seizures in epilepsy. She spoke about the common occurrence of multifactorial causes of SE, such as a child experiencing vomiting due to a viral illness, leading to missed medication doses and subsequent SE. Overall, she noted how these findings offer an opportunity to mitigate the unpredictability of seizures by recognizing early signs of these triggers and acting swiftly. Furthermore, Haridas stressed the importance of keeping family members close when discussing triggers of SE, and the need to have a plan in place for emergency measures during SE.
Click here for more AES 2024 coverage.
