Factores de riesgo asociados al estado epiléptico en pacientes de 1 mes de edad a 17 años ingresados en el Hospital Roberto Gilbert, 2019-2024.

Abstract

Introduction: Status epilepticus in children is a neurological emergency with a high morbidity and mortality rate, particularly in developing countries, due to its multifactorial etiology and the severity of the condition if it is not diagnosed and treated promptly, leading to irreversible neuromotor and cognitive sequelae. Objective: To describe risk factors associated with status epilepticus in children admitted between 2019 and 2024. Method: A descriptive, observational, retrospective study was conducted in patients aged 1 month to 17 years diagnosed with status epilepticus. Results: A total of 250 medical records were analyzed, revealing that the most common age group was preschoolers (35%) and infants (30%). Males accounted for 60.8% of the cases. 51.6% presented with established status epilepticus and 22.4% with refractory status epilepticus. A significant history of perinatal complications was identified (65.5%), notably extreme prematurity (25.2%) and hypoxic-ischemic encephalopathy (21.2%). Among patients previously treated, 42.4% had subtherapeutic antiepileptic drug levels. Among infectious causes, the isolation of Influenza A/B stood out at 11.2%. In the genetic screening performed on 64 patients, pathogenic variants were detected in genes such as STXBP1 and CDKL5 in 41 (64%) of the cases evaluated. Conclusions: Status epilepticus in children is characterized by a multifactorial profile in which vulnerability associated with early neurodevelopment, the presence of perinatal factors, poor treatment adherence, and underlying genetic causes are key determinants. Therefore, it is necessary to improve follow-up, optimize adherence, and expand access to genetic testing to guide management and prognosis.