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.
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.
Authors: Nicholas S Abend; Katherine L Wagenman; Taylor P Blake; Maria T Schultheis; Jerilynn Radcliffe; Robert A Berg; Alexis A Topjian; Dennis J Dlugos Journal: Epilepsy Behav Date: 2015-04-20 Impact factor: 2.937
Authors: Jonathan E Kurz; Samuel M Poloyac; Nicholas S Abend; Anthony Fabio; Michael J Bell; Mark S Wainwright Journal: Pediatr Crit Care Med Date: 2016-07 Impact factor: 3.624
Authors: Christopher M Ruzas; Peter E DeWitt; Kimberly S Bennett; Kevin E Chapman; Nicole Harlaar; Tellen D Bennett Journal: Neurocrit Care Date: 2017-04 Impact factor: 3.210
Authors: Nan Li; Ya Yang; David P Glover; Jiangyang Zhang; Manda Saraswati; Courtney Robertson; Galit Pelled Journal: J Neurotrauma Date: 2013-12-10 Impact factor: 5.269
Authors: Katherine L Wagenman; Taylor P Blake; Sarah M Sanchez; Maria T Schultheis; Jerilynn Radcliffe; Robert A Berg; Dennis J Dlugos; Alexis A Topjian; Nicholas S Abend Journal: Neurology Date: 2014-01-02 Impact factor: 9.910
Authors: Amy Yang; Daniel H Arndt; Robert A Berg; Jessica L Carpenter; Kevin E Chapman; Dennis J Dlugos; William B Gallentine; Christopher C Giza; Joshua L Goldstein; Cecil D Hahn; Jason T Lerner; Tobias Loddenkemper; Joyce H Matsumoto; Kendall B Nash; Eric T Payne; Iván Sánchez Fernández; Justine Shults; Alexis A Topjian; Korwyn Williams; Courtney J Wusthoff; Nicholas S Abend Journal: Seizure Date: 2014-10-05 Impact factor: 3.184