POST-TRAUMATIC EPILEPSY IN CHILDREN AFTER CLOSED HEAD INJURY

Objectives: High risk of post-traumatic epilepsy is characteristic for patients with penetrating head injuries – as much as 50% of them develop seizures. It is believed, that post-traumatic epilepsy is much less common after closed head injuries. The objective of this study was to determine the incidence of post-traumatic epilepsy in a group of children suffered moderate or severe closed head injury.

Methods: 283 patients aged from 4 to 14 years (201 boys and 82 girls) were examined in the period from 6 months to 4 years after they suffered moderate or severe closed head injury (contusion or diffuse axonal injury). The diagnosis was confirmed during hospitalization in the acute period of head injury. The principal criteria of head injury severity were the duration of consciousness loss and Glasgow Coma Scale score. Moderate closed head injury was diagnosed in 150 of patients and severe injury in 133 of them. The patients with post-traumatic epilepsy were selected from this group and passed clinical examination and EEG.

Results: 18 cases of epilepsy were revealed in the group of 283 patients after moderate or severe closed head injury. 16 patients (10 boys and 6 girls) or 5.7% developed secondarily generalized seizures during the period from 4 to 12 months after the injury; the severity of head injury was moderate in 12 and severe in 4 of them. In 2 of 18 patients head injury precipitated idiopathic generalized epilepsies: childhood absence epilepsy in a boy of 7 years of age and idiopathic epilepsy with grand mal seizures on awakening in a boy of 10 years of age.

Conclusion: Symptomatic post-traumatic epilepsy developed in 5.7% (16 of 283) of children suffered moderate or severe closed head injury. This incidence of post-traumatic epilepsy is rather high and it was not dependent on the patients' sex and age at injury.