J Korean Child Neurol Soc.  2012 Dec;20(4):228-233.

Clinical Characteristics of Post-traumatic Seizures in Children

Affiliations
  • 1Department of Pediatrics, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea. neuroandy@snubh.org
  • 2Pediatric Clinical Neuroscience Center, Department of Pediatrics, Seoul National University Children's hospital, Seoul, Republic of Korea.
  • 3Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • 4Department of Pediatrics, Seoul National University Boramae Hospital, Seoul, Republic of Korea.

Abstract

PURPOSE
Post-traumatic seizures (PTS) are well-recognized complications from head injuries and children are particularly more vulnerable to them. The aim of this study was to investigate the clinical characteristics of PTS in children and the findings of several diagnostic tools and to determine the role of prophylactic anticonvulsants.
METHODS
We retrospectively reviewed the medical records of patient under 18 years of age who presented with seizures after traumatic brain injuries. Data analyzed included patient's demographics, clinical presentations, radiological and electroencephalographic findings, management and outcomes.
RESULTS
Thirty one patients with PTS were included in the study and consisted of 13 males and 18 females. A mean age of the accident was 3.2 years (4 months-6.8 years) and a mean duration of follow-up was 26.0 months (12 months-54 months). Twenty one patients (67.7%) developed seizures within 24 hours after injury. Focal radiological findings were observed in 83.8% and described as subdural or epidural hematoma (25.8%), intraparenchymal hemorrhage (19.3%) and intracerebral parenchymal lesions (51.6%). Electroecephalographic findings included background abnormalities in 32.2% and interictal epileptiform discharges in 45.1%. All patients were treated with anticonvulsants for a certain period of time and a mean duration of treatment was 12.5 weeks (4-40 weeks). Eight patients (25.8%) developed subsequent seizures during follow-up period and 2 patients (6.5%) were diagnosed afterward with post-traumatic epilepsy.
CONCLUSION
PTS generally take a benign clinical course, but subsequent seizures including epileptic seizures can occur in minor proportion. In these cases, radiological and electroencephalographic findings are helpful in prediction of clinical course of PTS.

Keyword

Child; Post-traumatic seizure; Post-traumatic epilepsy; Traumatic brain injury

MeSH Terms

Anticonvulsants
Brain Injuries
Child
Craniocerebral Trauma
Demography
Epilepsy
Epilepsy, Post-Traumatic
Female
Follow-Up Studies
Hematoma
Hemorrhage
Humans
Male
Medical Records
Retrospective Studies
Seizures
Anticonvulsants
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