Benign Focal Epileptiform Discharges in Children After Severe Head Trauma: Prognostic Value and Clinical Course

Wohlrab, Gabriele; Schmitt, Bernhard; Boltshauser, Eugen

doi:10.1111/j.1528-1157.1997.tb01117.x

Cited by 7 publications

(2 citation statements)

References 17 publications

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“…PTE patients may have a single or multiple epileptic foci, most often in the frontal or the temporal lobe (Marks et al 1995;Wohlrab et al 1997;Diaz-Arrastia et al 2000;Hudak et al 2004;Diaz-Arrastia et al 2009) and may present with very localized or spreading focal seizures (Caveness 1963;Weiss and Caveness 1972;Walker and Blumer 1989). Ictal behaviors depend on the location of the epileptic focus, the pattern of seizures' spread and their duration and manifest as simple partial (Becker et al 1979;Salazar et al 1985Salazar et al , 1995Jabbari et al 1986;Pohlmann-Eden and Bruckmeir 1997), complex partial, or secondarily generalized tonic--clonic seizures (Caveness and Liss 1961;Becker et al 1979;Salazar et al 1985Salazar et al , 1995Wohlrab et al 1997). This heterogeneity in human PTE has been proposed to depend on variation in the type, location, severity, number of initiating injuries and of secondary insults, as well as on the different genetic backgrounds, ages, and genders of the victims (Caveness 1963;Caveness et al 1979).…”

Section: Introductionmentioning

confidence: 99%

Impact of Injury Location and Severity on Posttraumatic Epilepsy in the Rat: Role of Frontal Neocortex

Curia

Levitt²,

Fender³

et al. 2010

Cerebral Cortex

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Human posttraumatic epilepsy (PTE) is highly heterogeneous, ranging from mild remitting to progressive disabling forms. PTE results in simple partial, complex partial, and secondarily generalized seizures with a wide spectrum of durations and semiologies. PTE variability is thought to depend on the heterogeneity of head injury and patient's age, gender, and genetic background. To better understand the role of these factors, we investigated the seizures resulting from calibrated fluid percussion injury (FPI) to adolescent male Sprague-Dawley rats with video electrocorticography. We show that PTE incidence and the frequency and severity of chronic seizures depend on the location and severity of FPI. The frontal neocortex was more prone to epileptogenesis than the parietal and occipital, generating earlier, longer, and more frequent partial seizures. A prominent limbic focus developed in most animals, regardless of parameters of injury. Remarkably, even with carefully controlled injury parameters, including type, severity, and location, the duration of posttraumatic apnea and the age and gender of outbred rats, there was great subject-to-subject variability in frequency, duration, and rate of progression of seizures, indicating that other factors, likely the subjects' genetic background and physiological states, have critical roles in determining the characteristics of PTE.

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Section: Introductionmentioning

confidence: 99%

Impact of Injury Location and Severity on Posttraumatic Epilepsy in the Rat: Role of Frontal Neocortex

Curia

Levitt²,

Fender³

et al. 2010

Cerebral Cortex

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show abstract

“…Помимо типичной эпилептиформной активности по данным электроэнцефалографического исследования (ЭЭГ) при эпилепсии после ЧМТ могут регистрироваться графоэлементы, соответствующие критериям доброкачественных эпилептиформных паттернов детства (ДЭПД) [42]. ДЭПД не всегда клинически сопровождаются типичными тонико-клоническими приступами [43,44], хотя в 8-12% случаев и предшествуют развитию эпилепсии [45], которая, как правило, является возрастзависимой [43,46]. ДЭПД, равно Клинические наблюдения как и возрастзависимая эпилепсия, имеют особенность в виде исчезновения в пубертатном периоде [44].…”

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Severe brain trauma to the fetus in a car accident: Literature review and a clinical case

Vostrikov¹,

Ponomareva²,

Cheremisinov

et al. 2021

Alʹm. klin. med.

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Car accidents are the main cause of trauma during pregnancy. Even a non-severe accident is associated with a high risk of injury and unfavorable outcome for the fetus, especially in the event of placental abruption. Major agents leading to a trauma could also include safety belt and safety airbags. Blunt abdominal trauma during a car accident is associated with such type of intrauterine injury as fetal skull fractures and various intracranial hemorrhages. Despite a common viewpoint on relatively high death rates in this population, it is not infrequent that fetal trauma has a favorable outcome without any clinically significant neurological deficiency. The paper presents an analysis of the main outcomes of intrauterine brain injury and associated factors. As an illustration, we describe a case of a car accident related brain injury to a fetus at 38 week of gestation, with skull fracture, brain contusion, and subarachnoidal, epidural and subdural, parenchymal and intraventricular hemorrhages induced by the safety belt, with the mother being virtually uninjured. After treatment, the patient was discharged from the hospital in a satisfactory state, without clinically significant neurological symptoms and signs. A 8-months follow-up of the infant showed some delay in brain maturation manifesting as benign epileptiform discharges of childhood and magnetic resonance imaging patterns. It is highly likely, that the leading factors ensuring a favorable outcome of a intrauterine severe brain trauma (without fatal trauma to the mother and fetus) are as follows: correct obstetric strategy, late gestational age and absence of a massive parenchymal and/or intraventricular bleeding. After the short-term clinical recovery from a severe intrauterine brain trauma and in addition to it, proper follow-up of the child is essential because of a high risk of long-term cerebral and functional abnormalities, mostly paroxysmal, behavioral and cognitive.

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EEG in der Neuropädiatrie

Schmitt

Wohlrab

2012

Klinische Elektroenzephalographie

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Benign Focal Epileptiform Discharges in Children After Severe Head Trauma: Prognostic Value and Clinical Course

Cited by 7 publications

References 17 publications

Impact of Injury Location and Severity on Posttraumatic Epilepsy in the Rat: Role of Frontal Neocortex

Impact of Injury Location and Severity on Posttraumatic Epilepsy in the Rat: Role of Frontal Neocortex

Severe brain trauma to the fetus in a car accident: Literature review and a clinical case

EEG in der Neuropädiatrie

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