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Journal Article

Citation

Rabiu TB, Adetunmbi B. World Neurosurg. 2017; 104: 367-371.

Affiliation

Division of Neurological Surgery, Department of Surgery, Federal Teaching Hospital, Ido-Ekiti, Nigeria.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.wneu.2017.04.133

PMID

28461273

Abstract

BACKGROUND: Traumatic brain injury (TBI) is a recognized risk factor for seizures. In Nigeria, there is paucity of literature on post-traumatic seizures (PTS). This study provides the profile and pattern of PTS in TBI patients in a rural Nigerian neurosurgical service.

METHOD: A prospective observational study of TBI patients was done. Clinical and radiological data including outcomes of care were analysed with SPSS version 15. A p-value of <0.05 was considered statistically significant.

RESULT: 199 patients were managed for TBI. There were 20(10.1%) cases of PTS. Mean age was 28.4years (range: 5-80years) and most were males {16(80.0%)}. The average admission GCS was 10 (range: 3-15). Of the 20 PTS patients, 10(50.0%) had mild head injury while 3(15.0%) and 7(35.0%) had moderate and severe head injuries respectively. PTS peaked in young patients aged 17-45 years (14, 70%). Fourteen (14, 70.0%) had immediate PTS, while 6(30.0%) had early PTS. Increasing severity of head injury resulted in higher incidence of PTS (7.8%, 10.3% and 17.1% for mild, moderate and severe head injuries respectively).

FINDINGS of ASDH and contusions on CT scan are significant risk factors for PTS (Chi-square: 22.8; p-value: 0.0004). Five (25.0%) patients required anticonvulsant therapy because of seizure recurrence but only one progressed to late PTS. Four (20.0%) died while the rest had good outcome.

CONCLUSION: Severe TBI and CT findings of acute subdural haematoma and cerebral contusions are predictors of PTS in our environment. Progression of immediate/early to late PTS is rare.

Copyright © 2017 Elsevier Inc. All rights reserved.


Language: en

Keywords

Post traumatic seizures; post traumatic epilepsy; rural neurosurgery; traumatic brain injury

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