Post-traumatic epilepsy in children requiring inpatient rehabilitation following head injury
Post-traumatic epilepsy in children requiring inpatient rehabilitation following head injury
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DOI：
10.1136/jnnp.72.5.669
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发表时间：
2002-05-01
影响因子：
11
通讯作者：
Demellweek, C
中科院分区：
文献类型：
--
作者：
Appleton, RE;Demellweek, C
目的：研究某重型颅脑损伤住院康复患儿创伤后癫痫的患病率，并探讨其可能的危险因素。方法：回顾我院所有住院儿童的医院和社区病例记录以及临床脑电图科7年的记录，以确定脑损伤后发生迟发性癫痫的儿童。结果：1991年6月1日至1998年2月28日，102名儿童住院康复。这些患者的随访时间从18个月到8年多不等。9名患者（9%）在头部受伤后8个月至5年多期间发生创伤后癫痫。9名患者中有3名在受伤后的第一周出现了早期强直阵挛发作。其他检查的危险因素包括患者的年龄、头部损伤的原因、最初的格拉斯哥昏迷评分、神经影像学结果和呼吸支持的持续时间。只有早期癫痫发作（p = 0.002）和可能的格拉斯哥昏迷评分（p = 0.043）被发现是晚期晚期癫痫的特定危险因素。结论：创伤后癫痫似乎是罕见的，即使在儿童严重的头部损伤。在本研究人群中，早期癫痫发作可能表明发展为晚期创伤后癫痫的风险增加。
Objective: To study the prevalence of, and identify possible risk factors for, the development of post-traumatic epilepsy in a cohort of children with severe head injury treated in an inpatient rehabilitation unit.Methods: The hospital and community medical case notes of all children admitted prospectively to the unit and the records of the clinical EEG department over a seven year period were reviewed to identify those children who had developed late epilepsy after head injuries.Results: 102 children received inpatient rehabilitation between I June 1991 and 28 February 1998. Follow up of these patients ranged from 18 months to over eight years. Nine patients (9%) developed post-traumatic epilepsy between eight months and over five years after the head injury. Three of the nine patients had experienced early tonic-clonic seizures in the first week after the injury. Other risk factors examined included the age of the patient, the cause of the head injury, initial Glasgow coma scale score, neuroimaging findings, and duration of ventilatory support. Only the presence of early seizures (p = 0.002) and possibly the Glasgow coma scale score (p = 0.043) were found to be specific risk factors for late late epilepsy.Conclusions: Post-traumatic epilepsy appears to be uncommon, even in children with severe head injuries. Early seizures may indicate increased risk of developing late post-traumatic epilepsy in this study population.