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Published on: June 21, 2019
Young Age, Liver Dysfunction, and Neurostimulant Use as Independent Risk Factors for Post-Traumatic Seizures: A
Nicodemus Edrick Oey1, Pei Ting Tan2, Shrikant Digambarrao Pande2
1Rehabilitation Medicine, SingHealth Residency, Singapore 169608, Singapore.
Insights
Younger traumatic brain injury (TBI) patients with low GCS scores, cerebral contusions, or neurostimulant use face higher seizure risks. Close monitoring for post-TBI seizures is crucial for these individuals.
Area of Science:
- Neurology
- Neurosurgery
- Trauma Care
Background:
- Traumatic brain injury (TBI) can lead to long-term neurological deficits, including seizures.
- Identifying modifiable risk factors for post-TBI seizures is essential for improving patient outcomes.
- Previous research has explored various factors, but a comprehensive analysis of modifiable risks is still needed.
Purpose of the Study:
- To identify potentially modifiable risk factors predicting seizures after traumatic brain injury.
- To investigate the relationship between seizure risk and injury severity, interventions, and comorbidities.
Main Methods:
- Retrospective study of 151 patients with TBI admitted between March 2008 and October 2017.
- Analysis of data from 141 patients with complete follow-up records and no prior history of seizures.
- Statistical analysis to identify factors associated with the development of post-TBI seizures.
Main Results:
- 33 out of 141 patients (24.4%) developed seizures post-TBI.
- Younger age, presence of cerebral contusions, Indian race, low Glasgow Coma Scale (GCS) scores, and neurostimulant use were associated with increased seizure risk.
- Neurosurgical interventions were also noted in the context of increased seizure risk.
Conclusions:
- Younger TBI patients, those with low GCS scores, cerebral contusions, or on neurostimulants require vigilant monitoring for post-TBI seizures.
- The association between neurostimulant use and increased seizure risk warrants further investigation.
- Understanding these risk factors can guide targeted monitoring and management strategies for TBI patients.
Abstract:
We aimed to determine the potentially modifiable risk factors that are predictive of post-traumatic brain injury seizures in relation to the severity of initial injury, neurosurgical interventions, neurostimulant use, and comorbidities. This retrospective study was conducted on traumatic brain injury (TBI) patients admitted to a single center from March 2008 to October 2017. We recruited 151 patients from a multiracial background with TBI, of which the data from 141 patients were analyzed, as 10 were excluded due to incomplete follow-up records or a past history of seizures. Of the remaining 141 patients, 33 (24.4%) patients developed seizures during long-term follow up post-TBI. Young age, presence of cerebral contusion, Indian race, low Glasgow Coma Scale (GCS) scores on admission, and use of neurostimulant medications were associated with increased risk of seizures. In conclusion, due to increased risk of seizures, younger TBI patients, as well as patients with low GCS on admission, cerebral contusions on brain imaging, and those who received neurostimulants or neurosurgical interventions should be monitored for post-TBI seizures. While it is possible that these findings may be explained by the differing mechanisms of injury in younger vs. older patients, the finding that patients on neurostimulants had an increased risk of seizures will need to be investigated in future studies.
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