Factors Influencing Posttraumatic Seizures in Children

Abstract

Twenty-two adults with mild concussions were assessed 5 times during the first 3 months after injury. The initial tests were performed within 72 hours of injury. Each evaluation included a neurological examination and neuropsychological reaction time (RT) tests of simple and choice RT variations. The concussed subjects were compared with control subjects matched for age, sex, and education. The time of day of the testing was equated for the two groups. None of the concussed subjects had a significant neurological deficit and none was hospitalized. There was no significant difference in the number of errors by the two groups on the RT tests. On the simple RT test, requiring a predetermined response to a specific signal, there was no significant difference between the groups, although the concussed group was approximately 28 ms slower on the average than the control group. On the choice RT tests, however, which demand an increased amount of attention and information processing, the concussed subjects were significantly slower than the normal control group, especially during the 1st month after injury. Even after 3 months, the concussed subjects had not yet attained the skill of the control group. Analysis of the response curves over time suggested two processes: an improvement in the concussed group and a slowing in the control group. Within the concussed group, there was no correlation of RT with the severity of the concussion. Even mild concussions can cause significant attentional and information processing impairment in the absence of any apparent neurological problems. Specific neuropsychological tests are necessary to reveal the deficit. A significant impairment seems to last for several weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Early Post-Traumatic Seizures in Moderate to Severe Pediatric Traumatic Brain Injury: Rates, Risk Factors, and Clinical Features

“…Most seizures were prolonged or recurrent, but typically responded to treatment with a single AED. Our cohort corroborates the previously established EPTS risk factors of age < 2 years (Ong et al, 1996;Ratan et al, 1999), and severe TBI (Hahn et al, 1988;Marshall et al, 1992;Ong et al, 1996;Ratan et al, 1999), as well the less consistently reported risk factor of NAT (Barlow et al, 2000;Keenan et al, 2003), and SDH (Hahn et al, 1988;Ong et al, 1996). It also identified two other risk factors for EPTS: pre-hospital hypoxia and impact seizures.…”

“…Accurate identification of children at risk for EPTS can be difficult after moderate or severe TBI (Hahn et al, 1988;Lewis et al, 1993;Ratan et al, 1999). Younger age (Ong et al, 1996;Ratan et al, 1999), and more severe injury (Hahn et al, 1988;Marshall et al, 1992;Ong et al, 1996;Ratan et al, 1999), are the most consistently reported risk factors and are highlighted in the current guidelines for the management of severe TBI in children (Adelson et al, 2003).…”

“…Younger age (Ong et al, 1996;Ratan et al, 1999), and more severe injury (Hahn et al, 1988;Marshall et al, 1992;Ong et al, 1996;Ratan et al, 1999), are the most consistently reported risk factors and are highlighted in the current guidelines for the management of severe TBI in children (Adelson et al, 2003). Identification of additional risk factors for EPTS may further clarify which patients are likely to benefit from targeted therapy with AED prophylaxis, and limit administration of AEDs to children at very low risk.…”

The Diagnosis and Management of Concussion in Children and Adolescents

“…The risk increases further in patients with lower Glasgow Coma Scale scores at presentation. [139][140][141][142][143] In a large Danish population study, prior concussion imparted a twofold increased risk of epilepsy in children. 139 Risk was greatest within the first year after concussion, but remained increased for more than 10 years.…”

Compendio de las escalas de evaluación de riesgo en el paciente politraumatizado

“…La ISS, que es un sistema de puntuació n Tabla 2 -Escala del coma de Glasgow pediá trica Fuente: Hahn et al11 ; Raimondi et al12 .…”