Abstract Details

Title Outcomes in Children with Shaken Baby Syndrome and Seizures

Topic Child Neurology and Developmental Neurology

Presentation(s) P14 - Poster Session 14 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-009

Objective The present study aims to elucidate the factors contributing to poor outcomes in patients with acute seizures following Shaken Baby Syndrome (SBS).

Background SBS is the most common cause of severe neurological injury resulting from child abuse and is associated with subdural and retinal hemorrhages. Seizures are a common yet underdiagnosed feature of this syndrome and are associated with poor outcomes.

Design/Methods We retrospectively identified patients with SBS and seizures who were diagnosed between 2015-2020. Detailed chart review was performed under IRB-approved study criteria. Demographic, clinical, imaging, lab, and neurophysiology studies information was systematically collected. Logistic regression analysis was used to evaluate factors contributing to poor outcomes.

Results A total of 23 patients with acute seizures following SBS were included. The mean age was 7 months (range 3 weeks - 4 years). Six(26%) patients had a presenting GCS of 7 or less, while status epilepticus presented in 7(30%) patients. All included patients had acute traumatic subdural hematoma, retinal hemorrhage, and seizures in the acute period. Overall mortality was 2(9%). Logistic regression analysis identified craniotomy (p:0.01, OR:215.00; 95% CI 3.45-13408.47), SDH thickness >1 cm (p:0.02, OR:68.33; 95% CI 2.15-2173.12), midline shift >1 mm (p:0.03, OR:39.00; 95% CI 1.42-1067.60), and age >24 months (p:0.01, OR:215.00; 95% CI 3.45-13408.47) as predictors of mortality in both univariate and multivariate analysis. Of note, 19(83%) patients had an elevated serum glucose on presentation.

Conclusions

Seizures in Shaken Baby Syndrome are associated with acute traumatic subdural hematoma, and about 1 in 3 children will develop status epilepticus. Patients with craniotomy to evacuate SDH, SDH thickness >1 cm, midline shift >1 mm, and older age at the time of injury have a worse prognosis.

Authors/Disclosures
Katelyn Stebbins (Fralin Biomedical Research Institute at VTC) PRESENTER	Miss Stebbins has nothing to disclose.
Nasser Mohammed, MBBS (MD Anderson Cancer center)	Dr. Mohammed has nothing to disclose.
Aashit K. Shah, MD, FAAN (Carilion Clinic)	Dr. Shah has stock in Abbot, Abbivie, Gilead, Johnson and Johnson, Pfizer. The institution of Dr. Shah has received research support from Xenon Pharma.

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