Comparison of pediatric patients with status epilepticus lasting 5-29 min versus ≥30 min.

The most common thresholds for considering prolonged seizures as status epilepticus (SE) are 5 and 30 min. It is unknown whether these different thresholds (5 or 30 min) identify patient populations with different electroclinical characteristics. We compared the characteristics of patients with SE lasting 5-29 min (SE5-29) with those with SE lasting ≥30 min (SE≥30). Inclusion criteria were the following: 1) 1 month to 21 years of age at the time of SE, 2) convulsive seizures, and 3) seizure duration ≥5 min. Exclusion criteria were the following: 1) exclusively neonatal seizures, 2) psychogenic nonepileptic seizures, or 3) incomplete information about seizure duration. Four hundred forty-five patients (50.1% male) with a median (p25-p75) age at SE of 5.5 (2.8-10.5) years were enrolled. Status epilepticus lasted for 5-29 min in 296 (66.5%) of subjects and for ≥30 min in 149 (33.5%). Patients with SE≥30 were younger than the patients with SE5-29 at the time of seizure onset (median: 1 versus 2.1 years, p=0.0007). Status epilepticus as the first seizure presentation was more frequent in patients with SE≥30 (24.2% versus 12.2%, p=0.002). There was a tendency towards a higher rate of abnormalities in the magnetic resonance imaging at baseline in patients with SE≥30 (70.5% versus 57.1%, p=0.061). Differences were not detected in seizure frequency, seizure types, presence of developmental delay, and electroencephalogram abnormalities at baseline. In the pediatric population, SE thresholds of either 5 or 30 min identify groups of patients with very similar electroclinical characteristics, which may influence future definitions of pediatric SE.

Adolescents and Self-Reported Physical Activity: An Evaluation of the Modified Godin Leisure-Time Exercise Questionnaire.

The Godin Leisure-Time Exercise Questionnaire assesses self-reported physical activity (PA) among adults, and was later modified for children. However, the modified version (Godin-Child Questionnaire) has not been validated among adolescents. This study evaluates the construct validity and test-retest reliability of the Godin-Child Questionnaire among adolescents. The study participants, sixth graders (age M= 11.06 ± 0.436; 48% males, 48% Latino), were assessed at 2 time points (fall and spring: N= 139). First, the study determined whether adolescents accurately reported exercise intensity based on adolescents' ratings of perceived exertion (RPE) during moderate- and hard-intensity exercise tasks. Second, objective assessments of PA obtained using the Actigraph® accelerometer were correlated with PA self-reported on the Godin-Child Questionnaire. Third, test-retest correlations evaluated the Godin-Child Questionnaire for its reliability. Finally, interviews explored participants' interpretations of the Godin-Child Questionnaire. RPEs suggested that adolescents generally perceived exercise intensity accurately, with no significant differences between genders. There was a weak correlation between the Godin-Child Questionnaire and the Actigraph® during fall (r=.22, P< .05) and spring (r=.24, P<.05), with a significant correlation for males (P<.05) at both time periods. Test-retest correlations were acceptable (fall-spring r=.68; P<.001) and were equally strong among females and males. Interviews revealed that some respondents overlooked written directions. The Godin-Child Questionnaire may be a useful evaluative measure of self-reported physical activity for comparing activity levels across groups of adolescents, but may be less accurate for assessing physical activity on an individual level.

Comparison of risk factors for pediatric convulsive status epilepticus when defined as seizures ≥ 5 min versus seizures ≥ 30 min.

PURPOSE: To identify risk factors (RF) of pediatric convulsive status epilepticus (SE) and to determine whether defining SE as seizures ≥ 5 min (SE5) or seizures ≥ 30 min (SE30) would modify the risk factors identified. METHODS: Retrospective case-control study. We included patients 1 month to 21 years of age at the time of convulsive SE. We compared the characteristics of patients with SE (cases) versus those without SE (controls) using two different seizure duration thresholds: 5 min and 30 min. RESULTS: 1062 patients (54% males) were enrolled. The median (p25-p75) age at the episode was 6.4 (2.8-11.8) years. 444 (41.8%) patients had SE5 and 149 (14%) patients had SE30. On univariate analysis, risk factors for SE were not markedly different when considering a 5 or 30 min threshold. Compared to their respective controls patients with both SE5 and SE30 were younger at the age of seizure onset and at the age of SE, were on more antiepileptic drugs (AEDs) at baseline, had a higher rate of changes in AEDs in the three months prior to the episode, were more likely to have developmental delay at baseline, and a higher mortality rate. A higher baseline seizure frequency, and a higher increase in seizure frequency prior to the index episode were seen only in SE5. CONCLUSION: This series identifies RF which predict convulsive SE in pediatric patients. These RF are similar when considering a 5 min or a 30 min threshold for the definition of SE.