Post-traumatic early epilepsy in pediatric age group with emphasis on influential factors.
OBJECTIVE
Posttraumatic epilepsy in the pediatric age group is mostly seen within the first week. An acute posttraumatic epileptic fit, which may induce secondary insults, should be hindered. The aim of the study is to define the risk factors for posttraumatic early epilepsy (PTEE) and the indications for prophylactic therapy.


METHODS
In this survey, a total of 1,785 pediatric patients--under the age of 16--are studied. The majority of the patients (1,655) were treated in Haydarpaşa Numune Hospital within the years 1993-1999. The rest, which consists of 130 patients, were treated in Inönü University Turgut Ozal Medical Center between the years 2001 and 2003. The patients were categorized according to age, gender, neurological manifestations, type of trauma, cranial pathology, number and type of epileptic fits, the interval between trauma and convulsion, electroencephalogram findings, and antiepileptic therapy. All these factors were challenged due to their effect on the evolution of PTEE.


RESULTS
Only 149 cases had PTEE (8.4%). There was no correlation between gender and the incidence of PTEE. The data showed that 11.7% of the patients at or under the age of 3 (p=0.00072), 30.8% of the patients with severe head injury (Glasgow Coma Scale=3-8; Children's Coma Scale = 3-8; p=0.00000), 19.3% of the patients with depressed skull fractures (p=0.00038), 13.7% of the patients with intraparenchymal hemorrhage (p=0.0000072), and 21.6% of the patients with cerebral edema (p=0.000008) had PTEE. Only 20% of the patients with PTEE had a Glasgow Outcome Scale (GOS) of 3 or less (p=0.0000075).


CONCLUSIONS
Those patients at or under the age of 3, with severe head injury, cerebral edema, intraparenchymal hemorrhage, or depressed skull fracture, have a higher incidence of PTEE. Moreover, because the GOS of these patients are prone to be worse, antiepileptic therapy in acute stage may be effective in preventing the secondary brain damage.
Ateş
Ozkan
O
Department of Neurosurgery, School of Medicine, Turgut Ozal Medical Center, Inönü University, Malatya, Turkey. atesozkan@hotmail.com
Ondül
Sevim
S
Onal
Cağatay
C
Büyükkiraz
Mehmet
M
Somay
Hakan
H
Cayli
Süleyman R
SR
Göğüsgeren
Mehmet A
MA
Orakdöğen
Metin
M
Koçak
Ayhan
A
Yoloğlu
Saim
S
Berkman
Zafer
Z
Tevrüz
Mahir
M
D000293:Adolescent; D000367:Age Factors; D001929:Brain Edema / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications*; D004834:Epilepsy, Post-Traumatic / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D020300:Intracranial Hemorrhages / Q000150:complications*; D008297:Male; D012307:Risk Factors; D012887:Skull Fractures / Q000150:complications*; D013997:Time Factors; D014421:Turkey