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Updated: May 20, 2026
Use of a Wireless Video-EEG System to Monitor Epileptiform Discharges Following Lateral Fluid-Percussion Induced Traumatic Brain Injury
Published on: June 21, 2019
Posttraumatic seizures in children with severe traumatic brain injury
Jorge I Arango1, Christopher P Deibert, Danielle Brown
1Department of Neurosurgery and Neuroscience Research, Barrow Neurological Institute at Phoenix Children's Hospital, Ambulatory Building B, 1919 East Thomas Road, Phoenix, AZ 85016, USA.
Insights
Pediatric severe traumatic brain injury (TBI) can lead to seizures. Early posttraumatic seizures (EPTS) in children predict late seizures, highlighting the need for close monitoring and EEG in managing TBI.
Area of Science:
- Pediatric Neurology
- Trauma Surgery
- Neurocritical Care
Background:
- Traumatic brain injury (TBI) is a major cause of childhood death and disability globally.
- Seizures are a frequent complication of TBI, especially in pediatric cases.
- Optimal management strategies for severe pediatric TBI remain under investigation.
Purpose of the Study:
- To report institutional experience with severe pediatric TBI.
- To contribute evidence for improved management protocols for children with severe TBI.
- To analyze the incidence and predictors of seizures following pediatric TBI.
Main Methods:
- Retrospective chart review of patients aged 0 to <18 years with severe TBI.
- Analysis of demographics, injury details, clinical/radiological findings, and treatment.
- Seizure monitoring via EEG, clinical observation, and guardian reports.
Main Results:
- The incidence of early posttraumatic seizures (EPTS) was 19%, higher than previously reported.
- A significant association was found between EPTS and the development of late posttraumatic seizures (LPTS).
- Younger age and non-accidental trauma were independent predictors for seizure development.
Conclusions:
- Seizures are common in severe TBI among children aged 0-3 years.
- Close monitoring, including EEG, is crucial due to the adverse effects of seizures on the developing brain.
- Findings support the consideration of EPTS in the management of pediatric TBI patients.
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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