LO STATO EPILETTICO COME COMPLICANZA DI INTERVENTO CARDIOCHIRURGICO IN ETA PEDIATRICA

We report 24 children presenting with Status Epilepticus following cardiac surgery, representing the 0.6% of all the children submitted to correction of congenital heart defects in the period 1985-1993. 21 out of 24 required cardiopulmonary bypass; sixteen underwent surgery using profound hypotermia and circulatory arrest (mean arrest time: 63 min.). 8 children died, 2 had neurological sequelae, 12 had complete recovery, and 2 had no follow-up. All the children underwent continuous EEG monitoring during SE. SE was classified as partial somatomotor (12), partial with secondary generalization (1), unilateral alternating (4), erratic (5), unilateral not alternating (2). The incidence of SE is higher after surgery with prolonged circulatory arrest. The causes of seizures are multiple: embolization, hypoxic-ischemic injury; metabolic changes in the brain during prolonged hypothermia.