Sport-related concussive convulsions: a systematic review

Kuhl, Nicholas O.; Yengo‐Kahn, Aaron M.; Burnette, Hannah; Solomon, Gary S.; Zuckerman, Scott L.

doi:10.1080/00913847.2018.1419775

Cited by 18 publications

(7 citation statements)

References 20 publications

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“…[98][99][100] Concussive convulsion, in which brief posturing or other seizure-like activity is observed immediately after impact (in 1%-2% of cases), is thought to result from a transient loss of cortical inhibition (ie, have a nonepileptogenic cause) and is not associated with prolonged recovery from mTBI or the development of posttraumatic epilepsy. 101,102 Routine seizure prophylaxis is not recommended in any mTBI clinical practice guideline.…”

Section: Prognosismentioning

confidence: 99%

“…26 Musculoskeletal cervical complaints may respond to multifaceted physical therapy. 105 Pediatric considerations There is expert consensus that management of school-aged children and adolescents with mTBI should consider that (1) recovery time might be slower than adults, 102,135 (2) child-validated symptom rating scales and assessment tools, such as the Child SCAT5 109 are most appropriate, (3) return to activity advice to prevent reinjury should include nonsport play, 136 especially in unpredictable environments (eg, schoolyard), and (4) successful return to school (ie, symptom-free during school activities with no accommodations) should precede return to sport. 22,26…”

Section: Psychological Distressmentioning

confidence: 99%

See 1 more Smart Citation

Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines

Silverberg

Iaccarino

Panenka

et al. 2020

Archives of Physical Medicine and Rehabilitation

224

133

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At least 3 million Americans sustain a mild traumatic brain injury (mTBI) each year, and 1 in 5 have symptoms that persist beyond 1 month. Standards of mTBI care have evolved rapidly, with numerous expert consensus statements and clinical practice guidelines published in the last 5 years. This Special Communication synthesizes recent expert consensus statements and evidenced-based clinical practice guidelines for civilians, athletes, military, and pediatric populations for clinicians practicing outside of specialty mTBI clinics, including primary care providers. The article offers guidance on key clinical decisions in mTBI care and highlights priority interventions that can be initiated in primary care to prevent chronicity.

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Section: Prognosismentioning

confidence: 99%

Section: Psychological Distressmentioning

confidence: 99%

Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines

Silverberg

Iaccarino

Panenka

et al. 2020

Archives of Physical Medicine and Rehabilitation

224

133

View full text Add to dashboard Cite

show abstract

“…The current understanding is centred around studies on adults, and it is believed that impact seizures are not associated with abnormal neuroimaging findings, cognitive deficits, or prolonged concussion recovery. 18 Consequently, impact seizure was removed as a concussion modifying factor during the update of the 2017 Consensus Statement on Concussion in Sport. 1,17 The CSIG acknowledged that there was insufficient pediatric studies, and more research was required to prove or disprove this approach.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, when the concussion in sport group (CSIG) updated the consensus statement on concussion in sport in 2017, impact seizure was removed as a modifying factor in children and adolescents with SRCs, 1,17 but this was primarily based on adult literature suggesting that impact seizures are not associated with worse clinical outcomes in SRCs. 18 The objectives of this study were to evaluate the association of impact seizure on (1) the recovery time in children and adolescents with SRCs and (2) the choice reaction time as a possible prognostic factor.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Impact Seizure on the Recovery of Children and Adolescents With Concussion: A Matched Case–Control Study

Loo,

Fyffe,

Lam

et al. 2023

Clinical Journal of Sport Medicine

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Objective: Management of sport-related and recreation-related concussions (SRCs) in children and adolescents is challenging as brain maturation affects prognosis. However, impact seizure was removed as a prognosis modifying factor in children and adolescents with SRCs in the 2017 consensus statement on concussion in sport, based mostly on adult literature. Therefore, this study evaluates the association of impact seizure on the recovery in children and adolescents with SRCs. Design: Retrospective matched case–control study. Setting: Tertiary pediatric sports medicine service, from January 1, 2015, to June 30, 2022. Patients: A cohort of 452 patients, aged 7 to 18 years, with new episode of SRC was seen. From this cohort, 396 patients were included in the analysis, including 22 with impact seizures. Controls were generated using the propensity score matching approach. Patients with moderate or severe traumatic brain injury or incomplete treatment were excluded. Independent Variable: Impact seizure during SRC. Main Outcome Measures: Primary outcome was recovery duration in number of days. Results: The median recovery duration was longer in the cases (73 days, interquartile range [IQR] = 38-143 days) as compared with controls (49.5 days, IQR = 30.5-93.5 days). There was no difference in patients with prolonged recovery (ie >28 days) between both groups (OR 1.6, 95% CI, 0.4-6.6, P = 0.505). Conclusions: Impact seizures prolonged the recovery duration in children and adolescents with SRCs and have a potential concussion modifying the prognostic role. These findings could help provide evidence-based management principles for children and adolescents with SRCs in subsequent concussion consensus statements.

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“…Impact Seizure and Tonic Posturing are included in the criteria for all sports, except in NHL. Impact seizures following head trauma are uncommon 28 , but tonic posturing has been demonstrated to be common in sports such as Australian football. 22 Tonic posturing is often brief and can be difficult to identify.…”

Section: Video Signs Of Concussionmentioning

confidence: 99%

International study of video review of concussion in professional sports

et al. 2018

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BackgroundVideo review has become an important tool in professional sporting codes to help sideline identification and management of players with a potential concussion.AimTo assess current practices related to video review of concussion in professional sports internationally, and compare protocols and diagnostic criteria used to identify and manage potential concussions.MethodsCurrent concussion management guidelines from professional national and international sporting codes were reviewed. Specific criteria and definitions of video signs associated with concussion were compared between codes. Rules and regulations adopted across the codes for processes around video review were also assessed.ResultsSix sports with specific diagnostic criteria and definitions for signs of concussion identified on video review participated in this study (Australian football, American football, world rugby, cricket, rugby league and ice hockey). Video signs common to all sports include lying motionless/loss of responsiveness and motor incoordination. The video signs considered by the majority of sports as most predictive of a diagnosis of concussion include motor incoordination, impact seizure, tonic posturing and lying motionless. Regulatory requirements, sideline availability of video, medical expertise of video reviewers and use of spotters differ across sports and geographical boundaries. By and large, these differences reflect a pragmatic approach from each sport, with limited underlying research and development of the video review process in some instances.ConclusionsThe use of video analysis in assisting medical staff with the diagnosis or identification of potential concussion is well established across different sports internationally. The diagnostic criteria used and the expertise of the video review personnel are not clearly established, and research efforts would benefit from a collaborative harmonisation across sporting codes.

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Sport-related concussive convulsions: a systematic review

Cited by 18 publications

References 20 publications

Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines

Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines

The Effect of Impact Seizure on the Recovery of Children and Adolescents With Concussion: A Matched Case–Control Study

International study of video review of concussion in professional sports

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