The clinical characteristics of posttraumatic epilepsy following moderate-to-severe traumatic brain injury in children.
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.
['Keret|Amit|A|', 'Shweiki|Moatasim|M|', 'Bennett-Back|Odeya|O|', 'Abed-Fteiha|Fadia|F|', 'Matoth|Israel|I|', 'Shoshan|Yigal|Y|', 'Benifla|Mony|M|']
D000293:Adolescent D000070642:Brain Injuries, Traumatic D002648:Child D002675:Child, Preschool D018450:Disease Progression D000069279:Drug Resistant Epilepsy D004834:Epilepsy, Post-Traumatic D005260:Female D005500:Follow-Up Studies D006801:Humans D015994:Incidence D007223:Infant D008297:Male D012307:Risk Factors D013997:Time Factors
Traumatic brain injury Children Paediatric neurosurgery Post-traumatic epilepsy