Posttraumatic seizures in children with severe traumatic brain injury
Child's Nervous System, 07/31/2012
Clinical Article
Arango JI et al. – Seizures are a common complication of severe traumatic brain injury (TBI) among children aged 0–3 years. Given the detrimental effects that seizures produce on the injured brain, close observation and appropriate monitoring with EEG are essential for the management of children sustaining severe TBI.
Methods- Retrospective chart review was performed on individuals ages 0 to <18 who presented to a level 1 trauma center during a 10-year period with the diagnosis of severe TBI.
- Data analyzed included patient’s demographics, event information, clinical and radiological presentation, management, and midterm follow-up.
- Presence of seizures was tracked through EEG monitoring, staff witnessing, or guardian referral.
- The incidence of early posttraumatic seizures (EPTS) observed in the population (19 %) exceeds those previously reported.
- Such findings likely reflect the importance of close monitoring including EEG.
- An association between the presence of EPTS and the development of late posttraumatic seizures (LPTS) was evidenced (p=0.001; 95 % CI 2.2, 16.5), while this association should not be assumed as a measure of causality, it should be considered for the management of patients presenting EPTS.
- Non-accidental trauma and young age were identified as independent predictors for the development of seizures.
