Seizures after Severe Closed Head Injury
Shih-Tseng Lee, Tai-Ngar Lui, Cheuk-Wah Wong, Yi-Shen Yeh, Wen-Ching
Tzaan, Tzu-Yung Chen, Shang-Yu Hung and Chieh-Tsai Wu
Background: We studied the incidence and
clinical significance of early post-traumatic seizures after
severe closed head injury. Methods: This prospective
study is based on clinical observation of 3340 adult patients
with severe closed head injuries, each of them having a Glasgow
Coma Scale (GCS) 3 to 8 after trauma. Anticonvulsant agents
were not given to these patients unless there was evidence of
seizure. Results: One hundred and twenty-one patients
(3.6%) experienced seizures within 1 week after head injury;
42 of these (1.26% of the series) had seizures within 24 hours
after trauma. The incidence of intracerebral parenchymal damage
was found to be higher among those patients who developed seizures
in the first week (66.1%) than in those who did not (62.7%).
However this result did not reach statistical significance.
The patients with early seizures had a lower mortality rate
(p < 0.01). In patients who survived from the initial injury,
the occurrence of early post-traumatic seizures did not appear
to influence the neurological recovery at 6 months after injury.
Conclusion: Presence of intracerebral parenchymal
damage on CT scan after severe closed head injury does not increase
the risk of early post-traumatic seizures. With proper treatment,
patients presenting with early seizures may have a lower mortality
rate. However, the occurrence of early seizures does not influence
the neurological recovery in patients who survive the initial
severe closed head injury.
J. Neurol. Sci. 1997; 24: 40-43