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Related Concept Videos

Seizures: Classification01:13

Seizures: Classification

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Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
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Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
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Seizures in Children With Severe Traumatic Brain Injury.

Kimberly Statler Bennett1, Peter E DeWitt, Nicole Harlaar

  • 11Section of Pediatric Critical Care, Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO.2Department of Bioinformatics and Biostatistics, University of Colorado Denver, Aurora, CO.3Department of Pediatrics, Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO.4Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), Aurora, CO.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|September 23, 2016
PubMed
Summary

Young children with severe traumatic brain injury face higher risks of posttraumatic seizures, especially when abuse and subdural hemorrhage are present. These seizures are common even without these specific risk factors.

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Area of Science:

  • Pediatric neurology
  • Neurotrauma
  • Epidemiology

Background:

  • Traumatic brain injury (TBI) is a significant cause of death and disability in children.
  • Posttraumatic seizures (PTS) can exacerbate outcomes following TBI, but their risk factors remain unclear.
  • Understanding PTS predictors is crucial for improving pediatric TBI management.

Purpose of the Study:

  • To identify and clarify risk factors for PTS in a large cohort of pediatric patients with severe TBI.
  • To analyze the relationship between age, injury mechanism, and intracranial hemorrhage and PTS occurrence.
  • To quantify the probability of PTS based on combinations of these risk factors.

Main Methods:

  • Retrospective cohort study utilizing linked data from the National Trauma Data Bank and Pediatric Health Information Systems (2007-2010).
  • Inclusion criteria: 2,122 children (<18 years) with severe TBI (Glasgow Coma Scale < 8), prolonged hospital stay (>24 hours).
  • PTS identified via ICD-9-CM codes; predictors analyzed included age, injury mechanism (abuse/assault), and subdural hemorrhage.

Main Results:

  • PTS occurred in 25.2% of children with severe TBI.
  • Younger age (<2 years) was associated with higher PTS rates (36.6%) compared to older children (14-17 years, 16.4%) in the absence of abuse or subdural hemorrhage.
  • Age, abusive injury mechanism, and subdural hemorrhage were significant PTS predictors.
  • The combination of young age, abuse, and subdural hemorrhage conferred the highest estimated PTS probability (60%).

Conclusions:

  • The highest risk for PTS in pediatric severe TBI is associated with the triad of young age, abusive injury, and subdural hemorrhage.
  • PTS remain a common complication even when these specific risk factors are absent.
  • Further research into the complex interplay of these factors is warranted for targeted interventions.