title: Prevalence of epileptic and nonepileptic events after pediatric traumatic brain injury.
abstract: Though posttraumatic epilepsy (PTE) is a prominent sequela of traumatic brain injury (TBI), other nonepileptic phenomena also warrant consideration. Within two UCLA pediatric TBI cohorts, we categorized five spell types: 1) PTE; 2) Epilepsy with other potential etiologies (cortical dysplasia, primary generalized); 3) Psychopathology; 4) Behavior misinterpreted as seizures; and 5) Other neurologic events. The two cohort subsets differed slightly in injury severity, but they were otherwise similar. Overall, PTE occurred in 40%, other epilepsy etiologies in 14%, and nonepileptic spells collectively in 46%. Among children with spells, PTE was associated with severe TBI (p=0.001), whereas psychopathology (p=0.014) and epilepsy with other etiologies (p=0.006) were associated with milder TBI severity. Posttraumatic epilepsy (p=0.002) and misinterpreted behavior (p=0.049) occurred with younger injury age. Psychopathology (p=0.020) and other neurologic events (p=0.002) occurred with older injury age. In evaluating possible PTE, clinicians should maintain a broad differential diagnosis to prevent misdiagnosis and inappropriate treatment.
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, David Geffen School of Medicine at UCLA, USA. jmatsumoto@mednet.ucla.edu
authors.forename: Joyce H
authors.initials: JH
authors.lastname: Matsumoto
authors.forename: Rochelle
authors.initials: R
authors.lastname: Caplan
authors.forename: David L
authors.initials: DL
authors.lastname: McArthur
authors.forename: Marcy J
authors.initials: MJ
authors.lastname: Forgey
authors.forename: Sue
authors.initials: S
authors.lastname: Yudovin
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Giza
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001930:Brain Injuries / Q000150:complications*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D004569:Electroencephalography; D004834:Epilepsy, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D010372:Pediatrics; D015995:Prevalence; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*