Citation

Keret A, Shweiki M, Bennett-Back O, Abed-Fteiha F, Matoth I, Shoshan Y, Benifla M. Seizure 2018; 58: 29-34.

Affiliation

The pediatric Neurosurgery Unit, Rambam Health Care Campus, Haifa, Israel. Electronic address: M_Benifla@rmc.gov.il.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.seizure.2018.03.018

PMID

29609147

Abstract

PURPOSE: Children with traumatic brain injury (TBI) are at increased risk of posttraumatic epilepsy (PTE); the risk increases according to TBI severity. We examined the long-term incidence and risk factors for developing PTE in a cohort of children hospitalised at one medical centre with moderate or severe TBI.

METHODS: Moderate brain injury was classified as Glasgow Coma Score on Arrival (GCSOA) of 9-13, and severe brain injury as GCSOA ≤8. We collected demographics and clinical data from medical records and interviewed patients and parents at 5-11 years following the TBI event.

RESULTS: During a median follow-up period of 7.3 years, 9 (9%) of 95 children with moderate-to-severe TBI developed PTE; 4 developed intractable epilepsy. The odds for developing PTE was 2.9 in patients with severe compared to moderate TBI. CT findings showed fractures in 7/9 (78%) of patients with PTE, compared to 40/86 (47%) of those without PTE (p = 0.09). Of the patients with fractures, all those with PTE had additional features on CT (such as haemorrhage, contusion and mass effect), compared to 29/40 (73%) of those without PTE. One of nine (11%) PTE patients and 10 of 86 (12%) patients without PTE had immediate seizures. Two (22%) children with PTE had their first seizure more than 2 years after the TBI.

CONCLUSION: Among children with moderate or severe TBI, the presence of additional CT findings, other than skull fractures, seem to increase the risk of PTE. In our cohort, the occurrence of an early seizure did not confer an increased risk of PTE.

Copyright © 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Language: en

Keywords

Children; Paediatric neurosurgery; Post-traumatic epilepsy; Traumatic brain injury