title: Adding Insult to Injury: Nonconvulsive Seizures in Abusive Head Trauma.
abstract: The primary objectives of this study were to determine the prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in patients with abusive head trauma who underwent electroencephalography (EEG) monitoring and to describe predictive factors for this population. Children with a diagnosis of abusive head trauma were studied retrospectively to determine the rate of EEG monitoring, the rate of nonconvulsive seizures and nonconvulsive status epilepticus, and the associated neuroimaging findings. Over 11 years, 73 of 199 (36.8%) children with abusive head trauma had electroencephalography monitoring performed. Of these, 20 (27.4%) had nonconvulsive seizures and 3 (4.1%) had nonconvulsive status epilepticus. The presence of subarachnoid hemorrhage and cortical T2 / fluid-attenuated inversion recovery signal abnormalities were both significantly associated with the presence of nonconvulsive seizures / nonconvulsive status epilepticus. Nonconvulsive seizures are relatively common in abusive head trauma and may go unrecognized. Specific neuroimaging characteristics increase the likelihood of nonconvulsive seizures on EEG.
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA mary.greiner@cchmc.org.
authors.forename: Mary V
authors.initials: MV
authors.lastname: Greiner
authors.affiliation: Department of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Hansel M
authors.initials: HM
authors.lastname: Greiner
authors.affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Marguerite M
authors.initials: MM
authors.lastname: Caré
authors.affiliation: Department of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Deanna
authors.initials: D
authors.lastname: Owens
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Shapiro
authors.affiliation: Department of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Holland
mesh_terms: D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002649:Child Abuse; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D013226:Status Epilepticus / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology
keywords: EEG; child abuse; magnetic resonance imaging (MRI); status epilepticus; subarachnoid hemorrhage