Deteriorating situation for street children in Pakistan: A consequence of war

摘要

PGES occurs in between 8% of pediatric seizure patients (17) to 65% or more of adult patients with, generalized motor seizures (9) and has been reported in several monitored SUDEPear SUDEP cases (8-11,18,19) where some authors have used the term "cerebral shutdown" (19). Prolonged PGES may be an independent risk factor for SUDEP, but whether it is a surrogate marker or a direct index of cerebral and brainstem dysregula-tion is unclear. It has been shown that >50 seconds of PGES significantly increases the adjusted odds rations for SUDEP (5.22; 95% Cl, 1.26-21.58; p < 0.05) and for each 1 -second increase in the duration of PGES, the odds of SUDEP increases by a factor of 1.7% (95% Cl, 1.005-1.027; p < 0.005) (9). A recent study examining sympathetic and parasympathetic changes in seizure patients measured by electrodermal activity and heart rate variability (20). An increase in electrodermal activity response amplitude and a decrease in parasympathetic-modulated high-frequency power of heart rate variability were directly correlated to prolonged PGES.