EARLY SEIZURES AFTER SEVERE CLOSED-HEAD INJURY

Background: We studied the incidence and clinical significance of earl y post-traumatic seizures after severe closed head injury. Methods: Th is prospective study is based on clinical observation of 3340 adult pa tients with severe closed head injuries, each of them having a Glasgow Coma Scale (GCS) 3 to 8 after trauma. Anticonvulsant agents were not given to these patients unless there was evidence of seizure. Results: One hundred and twenty-one patients (3.6%) experienced seizures withi n 1 week after head injury; 42 of these (1.26% of the series) had seiz ures within 24 hours after trauma. The incidence of intracerebral pare nchymal damage was found to be higher among those patients who develop ed seizures in the first week (66.1%) than in those who did not (62.7% ). However this result did not reach statistical significance, The pat ients with early seizures had a lower mortality rate (p < 0.01). In pa tients who survived from the initial injury, the occurrence of early p ost-traumatic seizures did not appear to influence the neurological re covery at 6 months after injury. Conclusion: Presence of intracerebral parenchymal damage on CT scan after severe closed head injury does no t increase the risk of early post-traumatic seizures. With proper trea tment, patients presenting with early seizures may have a lower mortal ity rate. However, the occurrence of early seizures does not influence the neurological recovery in patients who survive the initial severe closed head injury.