Management of Post Traumatic Epilepsy in Pediatric Population in Pakistan

Abstract

Objective:  To investigate the efficacy of seizure prophylaxis in the prevention of early and late-onset seizures after the traumatic brain injury known as post-traumatic epilepsy (PTE).

Material and Methods:  A retrospective study was performed on children aged 0 to < 12 years who were presented to a level 1 trauma center during the six months with the diagnosis of mild to severe TBI. Data included is of 66 patients from Children’s Hospital, Lahore. It was analyzed according to a patient’s demographic data, mechanism of injury, clinical and radiological presentation, management, and follow-up. History of seizures was tracked through guardian referral or staff witnesses.

Results:  Among 66 pediatric cases of acute brain injury from June 2019 to December 2019, 45 were males (68%) and 21 were females (32%) with a male to female ratio of 2:1. The mean age in our study was 3.8 years. 60% of children were managed under observation, 30% of children required medical pharmacological treatment, 9% of children needed surgical intervention, and 13% of children required artificial ventilation. Overall mortality is 4.5%. In our study, we found a considerable relationship between residual neurological deficits and severity of injury (p = 0.3), there is no noteworthy relationship between mechanism of injury and outcome (p = 0.5). The mean length of stay was 3.9 days but 60% of patients had stayed less than 3 days.

Conclusion:  Analyzing the underlying mechanisms of post-traumatic epilepsy can lead us to propose effective treatments to prevent seizures following traumatic brain injury.