Early seizures after severe closed head injury.
BACKGROUND
We studied the incidence and clinical significance of early post-traumatic seizures after severe closed head injury.


METHODS
This prospective study is based on clinical observation of 3340 adult patients with severe closed head injuries, each of them having a Glasgow Coma Scale (GCS) 3 to 8 after trauma. Anticonvulsant agents were not given to these patients unless there was evidence of seizure.


RESULTS
One hundred and twenty-one patients (3.6%) experienced seizures within 1 week after head injury; 42 of these (1.26% of the series) had seizures within 24 hours after trauma. The incidence of intracerebral parenchymal damage was found to be higher among those patients who developed seizures in the first week (66.1%) than in those who did not (62.7%). However this result did not reach statistical significance. The patients with early seizures had a lower mortality rate (p < 0.01). In patients who survived from the initial injury, the occurrence of early post-traumatic seizures did not appear to influence the neurological recovery at 6 months after injury.


CONCLUSIONS
Presence of intracerebral parenchymal damage on CT scan after severe closed head injury does not increase the risk of early post-traumatic seizures. With proper treatment, patients presenting with early seizures may have a lower mortality rate. However, the occurrence of early seizures does not influence the neurological recovery in patients who survive the initial severe closed head injury.
Lee
S T
ST
Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
Lui
T N
TN
Wong
C W
CW
Yeh
Y S
YS
Tzuan
W C
WC
Chen
T Y
TY
Hung
S Y
SY
Wu
C T
CT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D005260:Female; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D014057:Tomography, X-Ray Computed
D000927:Anticonvulsants