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Posttraumatic seizures in children with severe traumatic brain injury

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Abstract

Purpose

Traumatic brain injury (TBI) remains a leading cause of childhood death and disability worldwide. Seizures are a common complication of TBI and they are particularly common in pediatric populations. The proper management of children sustaining severe TBI is still controversial. Our study aims to share our experience contributing to build evidence for better care.

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.

Results

The incidence of early posttraumatic seizures (EPTS) observed in our 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.

Conclusions

Seizures are a common complication of severe 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.

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Authors and Affiliations

  1. Department of Neurosurgery and Neuroscience Research, Barrow Neurological Institute at Phoenix Children’s Hospital, Ambulatory Building B, 1919 East Thomas Road, Phoenix, AZ, 85016, USA

    Jorge I. Arango, Danielle Brown & P. David Adelson

  2. Department of Neurosurgery and Critical Care Medicine, Children’s Hospital of Pittsburgh and the University of Pittsburgh, Pittsburgh, PA, USA

    Christopher P. Deibert & Michael Bell

  3. Nationwide Children’s Hospital Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA

    Igor Dvorchik

Authors
  1. Jorge I. Arango
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  2. Christopher P. Deibert
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  3. Danielle Brown
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  4. Michael Bell
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  5. Igor Dvorchik
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  6. P. David Adelson
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Corresponding author

Correspondence to P. David Adelson.

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Arango, J.I., Deibert, C.P., Brown, D. et al. Posttraumatic seizures in children with severe traumatic brain injury. Childs Nerv Syst 28, 1925–1929 (2012). https://doi.org/10.1007/s00381-012-1863-0

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  • DOI: https://doi.org/10.1007/s00381-012-1863-0

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