In children as in adults, mild brain injury elevates risk of posttraumatic epilepsy

Posttraumatic epilepsy is a known risk for adults who have suffered mild traumatic brain injury (MTBI). The same risk exists for children and teens, according to a longitudinal study published online May 5 in the Journal of Neurosurgery: Pediatrics.

Mony Benifla, MD, and colleagues at Hadassah Medical Center in Jerusalem, Israel, prospectively followed up with 191 children who had been admitted to the hospital aged infant to 17 years with a diagnosis of MTBI between 2007 and 2009.

The team surveyed the patients or their caregivers by phone between 2015 and 2016, asking about epileptic episodes as well as current seizure and neurological status. The mean follow-up was 7.4 years.

All patients underwent CT imaging. Some 72.8 percent had fractures, mostly from falls, while 10.5 percent did not have acute findings.

Seven children (3.7 percent) experienced posttraumatic seizure. Of them, six (85.7 percent) developed epilepsy and three (42.9 percent) developed intractable epilepsy.

Interestingly, none whose posttraumatic seizure occurred immediately upon injury developed any epilepsy at all.  

Children who developed epilepsy spent an average of two extra days in the hospital at the time of the injury, the authors report, while the mean time between trauma and onset of seizures was 3.1 years.

Upon completion of data analysis and long-term follow-up, the authors found that MTBI had conferred increased risk for the development of posttraumatic epilepsy and intractable posttraumatic epilepsy at 4.5 and 8 times higher than baseline, respectively.

“As has been established in adults, these findings confirm that MTBI increases the risk for posttraumatic epilepsy in the pediatric population,” they conclude.