Citation

Mariajoseph FP, Chen Z, Sekhar P, Rewell SS, O'Brien TJ, Antonic-Baker A, Semple BD. Epilepsia 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, John Wiley and Sons)

DOI

10.1111/epi.17398

PMID

35996866

Abstract

Post-traumatic epilepsy (PTE) is a well-known chronic complication following traumatic brain injury (TBI). Despite some evidence that age at the time of injury may influence the likelihood of PTE, the incidence of PTE in pediatric populations remains unclear. We therefore conducted a systematic review to determine the overall reported incidence of PTE, and explore potential risk factors associated with PTE after pediatric TBI. A comprehensive literature search of PubMed, Embase and Web of Science databases was conducted, including randomized controlled trials and cohort studies assessing the incidence of PTE in TBI pediatric patients. We excluded studies with a sample size <10 patients and those in which a pediatric cohort was not clearly discernable. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We found that the overall incidence of PTE following pediatric TBI was 10% (95% confidence interval [CI]: 5.9% - 15%). Subgroup analysis of a small number of studies demonstrated that the occurrence of early seizures (cumulative incidence ratio [CIR]: 7.28, 95% CI: 1.09 - 48.4, p=0.040), severe TBI (CIR: 1.81, 95% CI: 1.23 - 2.67, p<0.001) and intracranial hemorrhage (CIR: 1.60, 95% CI: 1.06 - 2.40, p=0.024) increased the risk of PTE in this population. Other factors including male sex, and neurosurgical intervention were non-significantly associated with a higher incidence of PTE. In conclusion, PTE is a significant chronic complication following childhood TBI, similar to in the adult population. Further standardized investigation into clinical risk factors and management guidelines is warranted.

PROSPERO: CRD42021245802.

Language: en

Keywords

pediatric; incidence; Traumatic brain injury; childhood; epilepsy; neurotrauma; post-traumatic epilepsy; seizure