Abstract Details

Title Timing Matters: Early Post Traumatic Seizures in a Pediatric Population

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P01 - (-)

Poster/Presentation
Number 024

Objective

Background Traumatic brain injury (TBI) is often associated with seizure activity. Seizures occurring within minutes of TBI ("impact seizures") may carry a better prognosis but EPTS (onset <1 week) have been identified as a risk factor for development of epilepsy. Less is known about seizures with very early onset (<24 hours).

Design/Methods Consecutive TBI admissions were prospectively enrolled at two academic medical centers. 87 of 92 patients were placed on continuous EEG monitoring for at least 12 hours. Outcomes were measured by the King's Outcome Scale for Childhood Head Injury (KOSCHI). Clinical characteristics of the injury were collected. Statistical analyses were performed with R, version 2.15.1.

Results 31 of 92 (34%) patients had at least one type of seizure with a clear onset time post-injury. 17 patients had seizures within one hour of injury and 14 had their first seizure after one hour. Those with first EPTS <1 hour post-injury had similar KOSCHI scores to patients without EPTS (p=0.99). Individuals with first EPTS >1 hour post-injury had worse KOSCHI scores compared to patients without EPTS (p=0.04). There was also a significant relationship between EPTS onset >1 hour and TBI severity (p=0.02) and with injury mechanism (p=0.04, less likely due to falls).

Conclusions EPTS that began >1 hour after injury were related to greater TBI severity, injury mechanism and worse outcomes. Seizures that occurred within the first hour after head trauma were not associated with TBI severity, injury mechanism or worse short-term outcomes. Very early post-TBI seizure events may include impact seizures as well as non-epileptic events (such as brief posturing, syncope, etc), which are distinct from medically observed EPTS and have different prognostic implications.

Authors/Disclosures
Michael Su, MD (UCLA Medical Center) PRESENTER	Dr. Su has nothing to disclose.
	No disclosure on file
Jason Lerner, MD (Biohaven)	Dr. Lerner has received personal compensation for serving as an employee of Biohaven Pharmaceuticals. Dr. Lerner has or had stock in Biohaven Pharmaceuticals.
Daniel H. Arndt, MD	No disclosure on file
	No disclosure on file
Joyce H. Matsumoto, MD	Dr. Matsumoto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gerson Lehman Group.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Christopher Giza, MD, FAAN (UCLA, Depts of Pediatrics and Neurosurgery)	Dr. Giza has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medical Network Speakers Bureau. Dr. Giza has stock in Highmark Interactive. The institution of Dr. Giza has received research support from UCLA: Brain Injury Research Center, Steve Tisch BrainSPORT Program, Easton Clinic for Brain Health. Dr. Giza has received publishing royalties from a publication relating to health care. Dr. Giza has a non-compensated relationship as a Advisory Board with Major League Soccer that is relevant to AAN interests or activities. Dr. Giza has a non-compensated relationship as a Advisory Board with National Basketball Association that is relevant to AAN interests or activities. Dr. Giza has a non-compensated relationship as a Consultant with United States Soccer Federation that is relevant to AAN interests or activities. Dr. Giza has a non-compensated relationship as a Co-founder & Advisor with Symptomwise that is relevant to AAN interests or activities.

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