EARLY POSTTRAUMATIC SEIZURES IN CHILDREN - CLINICAL AND RADIOLOGICAL ASPECTS OF INJURY

Objective: To determine the type and outcome of early post-traumatic s eizures in children and the factors associated with it. Methodology: A prospective observational study on all consecutive children with head injuries at the General Hospital Kuala Lumpur between November 1993 a nd December 1994. The onset, type and frequency of seizures occurring within the first week of injury were documented. Using inpatients as a cohort, logistic regression analysis was used to determine clinical a nd radiological variables significantly associated with seizures. The outcome 6 months post-injury was assessed using the Glasgow Outcome Sc ale. Results: Fifty-three of 966 children (5.5%) developed seizures wi thin the first week of trauma. Seven (13.2%) occurred within 1 h of in jury, 30 (56.6%) between 1 and 24 h and 16 (30.2%) after 24 h. Factors significantly associated with early post-traumatic seizures were fema le sex, age less than 2 years, loss of consciousness for more than 24 h and acute subdural haematoma (P<0.01). Children with seizures had a poorer outcome (death or severe disability) than inpatients without se izures (21/53 vs 19/182, P<0.001). The outcome was worst in children w ith recurrent partial seizures, who had a longer injury-seizure interv al and were more likely to have focal neurologic deficits compared to those with sporadic or generalized seizures. Conclusions: Anticonvulsa nt prophylaxis to minimize the adverse effects of early seizures in he ad injury should be considered for young children (less than 2 years o ld) with subdural haematoma and a prolonged duration of coma. Prompt a nd effective control of recurrent seizures is recommended.