Abstracts

Rationale: The accident is the most common problem during childhood period; especially the head injury is the significant medical problem. The development of seizure after head trauma- posttraumatic seizure (PTS) is clinically important. We would like to know about the risk factors associated with clinical, neurophysiological and neuroradiological variables for PTS. Methods: The medical records of 472 children with seizures after head trauma under 15 years old, who admitted to the Wonju Christian Hospital, were retrospectively reviewed. The patients were divided to early PTS, that seizure occurs within 1 week after head trauma and late PTS that occurs beyond the first week. The severity of head injuries was classified by Glasgow Coma Scale; mild, 13 to 15, moderate 9 to 12, and severe below 9. The variables such as age, sex, duration of unconsciousness, GCS, brain CT finding, initial neurological finding and anticonvulsants therapy were analyzed for risk factors of PTS. Results: The rate of PTS was 12.3%; early 8.7%, late 3.6%. Among early PTS 77.8% had seizure within 24 hours after head trauma and the 82.3% of late PTS had seizure within 1 year. The 86.2% of PTS was seizure free within 1 year. The frequency of seizures during the first one year is that 58.6% is less than two episodes. The frequency and duration of PTS were not correlated with latency of onset of seizure after head trauma. The most common seizure type of PTS was generalized tonic-clonic; early PTS 82.9%, late PTS 76.5%. There was the significant difference in the incidence of PTS by severity of head trauma; mild 5.8%, moderate 13.0%, and severe 29.2%. The risk factors of PTS are lower GCS than 12, under 2 year old, intracranial hemorrhage, and longer coma state than 24 hours. Conclusions: The risk factors of PTS were correlated with severity of head trauma. Therefore it is concerned that PTS should be prevented in severe head trauma patients.