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Journal of the Korean Child Neurology Society 2012;20(4):228-233.
Published online December 30, 2012.
Clinical Characteristics of Post-traumatic Seizures in Children.
Jon Soo Kim, Hye Won Ryu, Sung Hwan Byun, Hunmin Kim, Byung Chan Lim, Jong Hee Chae, Jieun Choi, Ki Joong Kim, Yong Seung Hwang, Hee Hwang
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.
Key Words: Child, Post-traumatic seizure, Post-traumatic epilepsy, Traumatic brain injury


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