OUTCOMES OF ACUTE SEIZURE MANAGEMENT IN CHILDREN AT THE EMERGENCY AND POISON CONTROL DEPARTMENT, VIETNAM NATIONAL CHILDREN’S HOSPITAL
##plugins.themes.vojs.article.main##
Abstract
Background: Acute seizures are among the most common neurological emergencies in children. Evaluating seizure management is essential for optimizing treatment and standardizing emergency care.
Objective: To describe the clinical characteristics and evaluate the outcomes of acute seizure management in children treated at the Emergency and Poison Control Department, Vietnam National Children’s Hospital.
Methods: A prospective descriptive study was conducted in 100 children aged 1 month to 15 years with acute seizures admitted between September 2025 and May 2026. Clinical characteristics, treatment modalities, and seizure control outcomes were collected and analyzed.
Results: Children aged 13–59 months accounted for 52.0% of the study population, and 52.0% were male. Epilepsy was the most common diagnosis (70.0%). Intravenous midazolam was administered in 87.0% of patients. Benzodiazepines successfully terminated seizures in 78.0% of cases, with 62.0% responding after the first dose. Second-line antiseizure medications were required in 22.0% of patients, while 3.0% required third-line therapy or general anesthesia and 2.0% required endotracheal intubation. Children aged ≥ 5 years had a higher risk of benzodiazepine failure (OR = 2.90, 95% CI: 1.09–7.71; p = 0.029).
Conclusions: In this study, benzodiazepines achieved seizure control in 78.0% of children with acute seizures. Early assessment of treatment response and timely escalation of therapy may improve seizure control.
##plugins.themes.vojs.article.details##
Keywords
acute seizures, children, benzodiazepines, pediatric emergency medicine
References
2. Glauser T, Shinnar S, Gloss D et al. Evidence-based guideline: Treatment of convulsive status epilepticus in children and adults: Report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr 2016;16(1):48-61. https://doi.org/10.5698/1535-7597-16.1.48
3. Freedman DA, Roach ES. Status epilepticus. Pediatr Rev 2023;44(7):383-92. https://doi.org/10.1542/pir.2022-005632
4. Abbasi A, Kazi G, Siddiqui S et al. Clinical profile and management of children with seizures presenting to the pediatric emergency department: A cross-sectional study. Int J Surg Open 2020;27:188-92. https://doi.org/10.1016/j.ijso.2020.11.017
5. Sartori S, Nosadini M, Tessarin G et al. First-ever convulsive seizures in children presenting to the emergency department: Risk factors for seizure recurrence and diagnosis of epilepsy. Dev Med Child Neurol 2019;61(1):82-90. https://doi.org/10.1111/dmcn.14015
6. Bùi Thu Phương, Phạm Thị Thuận. Đặc điểm dịch tễ học, lâm sàng và nguyên nhân co giật do sốt ở trẻ em tại Bệnh viện Trung ương Quân đội 108. Tạp chí Nhi khoa 2022;15(5). https://doi.org/10.52724/tcnk.v15i5.160
7. Welch RD, Nicholas K, Durkalski-Mauldin VL et al. Intramuscular midazolam versus intravenous lorazepam for the prehospital treatment of status epilepticus in the pediatric population. Epilepsia 2015;56(2):254-262. https://doi.org/10.1111/epi.12905
8. Turan B, Kanmaz S, Turan C et al. Efficacy and safety of the revised Ege Pediatric Status Epilepticus Protocol (r-EPSEP). J Child Neurol 2026;41(1):24-33. https://doi.org/10.1177/08830738251346214
9. Lewena S, Pennington V, Acworth J et al. Emergency management of pediatric convulsive status epilepticus: A multicenter study of 542 patients. Pediatr Emerg Care 2009;25(2):83-7. https://doi.org/10.1097/pec.0b013e318196ea6e
10. Shinnar S, Pellock JM, Moshé SL et al. In whom does status epilepticus occur: age-related differences in children. Epilepsia 1997;38(8):907-914. https://doi.org/10.1111/j.1528-1157.1997.tb01256.x
11. Vasquez A, Gaínza-Lein M, Abend NS et al. First-line medication dosing in pediatric refractory status epilepticus. Neurology 2020;95(19). https://doi.org/10.1212/wnl.0000000000010828
12. Gaínza-Lein M, Sánchez Fernández I, Jackson M et al. Association of time to treatment with short-term outcomes for pediatric patients with refractory convulsive status epilepticus. JAMA Neurol 2018;75(4):410-418. https://doi.org/10.1001/jamaneurol.2017.4382