Abstract Details

Title Post-traumatic Epilepsy Timing and Treatment Response in Young Patients with Abusive Head Trauma

Topic Child Neurology and Developmental Neurology

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 8-007

Objective

To evaluate the timing and treatment-response of post-traumatic epilepsy (PTE) within 3 years after abusive head trauma (AHT).

Background Approximately 30% of children with traumatic brain injury develop PTE. Understanding the timing from injury to PTE onset has been difficult, especially for patients with AH. We previously described 31 patients with AHT and subsequent PTE. Little is known about the development of PTE in young children with AHTor how such patients respond to treatment.

Design/Methods We utilized a database of 373 patients admitted for AHT to our institution between 2012-2020. The majority (263/373, 70.5%) were followed in our multidisciplinary clinic (MDC), and 31 (11.8%) developed PTE. We completed extensive chart review for 23 patients who were less than 3 years old at the time of AHT and developed PTE within 3 years.

Results Half (12/23) presented with infantile (epileptic) spasms (IS) – these will be described in a later study. The other half (11/23) presented with myoclonic seizures, focal seizures, and/or tonic seizures; 2 went on to develop IS. The median time from AHT to PTE diagnosis and treatment initiation was 259 days (median age 380 days). Many patients demonstrated non-epileptic spells before their diagnosis, but most guardians appropriately recognized epileptic seizures within one week of onset and reached out to Neurology, who arranged confirmation with EEG in 8/12. The majority (10/11) had a least a partial improvement in seizures with the first treatment (levetiracetam 9/11), and two-thirds had fewer than 4 seizures/year by 2 years after PTE diagnosis.

Conclusions atients with AHT are at risk for developing PTE within the first 3 years after their initial injury. Of the half who did not present with IS, most exhibited at least partial improvement with one or two antiseizure medications after 2 years. Future studies will evaluate long-term outcomes.

Authors/Disclosures
Ricka Messer, MD (Children'S Hospital Colorado) PRESENTER	The institution of Dr. Messer has received research support from Ultragenyx Pharmaceutical Inc. Dr. Messer has a non-compensated relationship as a Chair of the Pediatric Neurology Specialty Steering Board with Epic that is relevant to AAN interests or activities. Dr. Messer has a non-compensated relationship as a Member of the AAN Quality Informatics Subcommittee with ��ɫ�� that is relevant to AAN interests or activities.
Casey Madison	No disclosure on file
Amy Connery	Amy Connery has nothing to disclose.

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