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Factors predictive of outcome in posttraumatic seizures.

Wang HC, Chang WN, Chang HW, Ho JT, Yang TM, Lin WC, Chuang YC, Lu CH

Departments of Neurosurgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, China.

BACKGROUND: Seizures are important neurologic complications of traumatic brain injury (TBI). There is a need for better delineation of potential prognostic factors and outcomes in patients with posttraumatic seizures (PTS) who could receive treatment when brought to the hospital. METHODS: In this 10-year retrospective study, 170 adult patients with PTS were enrolled in this study. The degree of seizure control was analyzed using a Seizure Frequency Scoring System, which classified them into excellent and nonexcellent outcomes. RESULTS: There were 170 patients with acute symptomatic seizure enrolled in this study, 106 of whom had early PTS, whereas 64 had late PTS. Of the 106 early PTS, 58% (61 of 106) occurred within 24 hours of trauma. Risk factors for developing nonexcellent outcome included patients who undergo surgical intervention and presence of late-provoked seizures during the acute phase of TBI. CONCLUSIONS: Seizures are an important neurologic complication of TBI. Regarding the potentially side effects of antiepileptic drugs, antiepileptic therapy should be carefully administrated in those nonexcellent outcome patients.

Published 11 April 2008 in J Trauma, 64(4): 883-8.
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