Occurrence of early epilepsy in children with traumatic brain injury: a retrospective study

• Published in: World journal of pediatrics : WJP Vol. 18; no. 3; pp. 214 - 221
• Main Authors: Ji, Jian, Qian, Su-Yun, Liu, Jun, Gao, Heng-Miao
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.03.2022; Pediatric Intensive Care Unit,National Center for Children's Health,Beijing Children's Hospital,Capital Medical University,No.45 Nanlishi Road,Beijing 100045,China
• Subjects: Anticonvulsants - therapeutic use; Brain Injuries, Traumatic - complications; Brain Injuries, Traumatic - diagnosis; Brain Injuries, Traumatic - epidemiology; Child; Critical Care Medicine; Epilepsy - diagnosis; Epilepsy - epidemiology; Epilepsy - etiology; Epilepsy, Post-Traumatic - epidemiology; Epilepsy, Post-Traumatic - etiology; Epilepsy, Post-Traumatic - prevention & control; Fever; Humans; Imaging; Intensive; Maternal and Child Health; Medicine; Medicine & Public Health; Original Article; Pediatric Surgery; Pediatrics; Radiology; Retrospective Studies; Seizures - diagnosis; Surgery; Traumatic brain injury; Children; Risk factors; Early post-traumatic seizures
• ISSN: 1708-8569; 1867-0687
• DOI: 10.1007/s12519-021-00502-4

Background Early post-traumatic seizures (EPTS) refer to epileptic seizures occurring within one week after brain injury. This study aimed to define the risk factors of EPTS and the protective factors that could prevent its occurrence. Methods This is a single-center retrospective study in the PICU, Beijing Children's Hospital. Patients diagnosed with traumatic brain injury (TBI), admitted with and without EPTS between January 2016 and December 2020 were included in the study. Results We included 108 patients diagnosed with TBI. The overall EPTS incidence was 33.98% (35/108). The correlation between EPTS and depressed fractures is positive ( P  = 0.023). Positive correlations between EPTS and intracranial hemorrhage and subarachnoid hemorrhage had been established ( P  = 0.011and P  = 0.004, respectively). The detection rates of EPTS in the electroencephalogram (EEG) monitoring was 80.00%. There was a significant difference in the EEG monitoring rate between the two groups ( P  = 0.041). Forty-one (37.86%, 41/108) post-neurosurgical patients were treated with prophylactic antiepileptic drugs (AEDs), and eight (19.51%, 8/41) still had seizures. No statistical significance was noted between the two groups in terms of prophylactic AEDs use ( P  = 0.519). Logistic regression analysis revealed that open craniocerebral injury and fever on admission were risk factors for EPTS, whereas, surgical intervention and use of hypertonic saline were associated with not developing EPTS. Conclusions Breakthrough EPTS occurred after severe TBI in 33.98% of pediatric cases in our cohort. This is a higher seizure incidence than that reported previously. Patients with fever on admission and open craniocerebral injuries are more likely to develop EPTS.