Posttraumatic Seizures in Children: Risk Factors and Prophylactic Antiepileptic Drugs.

Ryou, Kyoung Soo; Hwang, Sung Kyoo; Hwang, Jeong Hyun; Hamm, In Suk; Kim, Seung Lae

Original Article

Journal of Korean Neurosurgical Society 2002;32(5): 443-447.

Kyoung Soo Ryou, Sung Kyoo Hwang, Jeong Hyun Hwang, In Suk Hamm, Seung Lae Kim

Department of Neurosurgery, Kyungpook National University, School of Medicine, Daegu, Korea. shwang@knu.ac.kr

ABSTRACT

OBJECTIVE
Identification of risk factors and prevention of the seizures are very important in the management of the pediatric traumatic brain injury(TBI). The authors conduct a study to find the risk factors of the pediatric posttraumatic seizures(PTS) and effectiveness of the prophylactic antiepileptic drugs(AED).
METHODS
We respectively analyzed 82 pediatric patients below the age of 15 who visited our hospital with TBI from August 1995 to May 2001. Mean age at arrival was 6.1 years, ranging from 2 months to 15 years. Male to female ratio was 1.9 : 1. Mean follow-up period was 3.9 months ranging from 0.5 to 42 months.
RESULTS
Among the 82 patients, 13(15.8%) experienced PTS. In eight of the 13 seizure patients, the seizures developed within 24 hours after trauma. Patients with Glascow coma scale score less than 8 had higher rate of seizure attack. Forty-seven patients(58%) used AED within 24 hours after trauma. Among them, two patients experienced seizure attacks. Among the other 35 patients who had not received prophylactic AED, 11 patients(31%) had seizures with significantly higher rate of PTS.
CONCLUSION
PTS are common complication in pediatric TBI. Use of prophylactic AED in the early stage of TBI can reduce the development of early seizures.

Key Words: Traumatic brain injury; Posttraumatic seizure; Early seizure; Antiepileptic drug