Risk Factors and Phenytoin Prophylaxis for Early Post-Traumatic Seizures among Patients with Traumatic Brain Injury
- Author:
Chan Kin Hup
;
John Tharakan
;
Hillol Kanti Pal
;
Naeem Khan
;
Tan Yew Chin
- Publication Type:Journal Article
- Keywords:
post-traumatic epilepsy, traumatic brain injury, head injuries, incidence, risk factors, phenytoin
- From:Malaysian Journal of Medical Sciences
2010;17(4):36-43
- CountryMalaysia
- Language:English
-
Abstract:
Background: Post-traumatic seizure is a well-known and serious complication of traumatic
brain injury (TBI). The incidence and risk factors vary among study populations. Very little data
have been published concerning this in the Malaysian population. The aim of this study was to
ascertain the risk factors for the development of early post-traumatic seizures among patients with
TBI.
Methods: This was a prospective observational study, carried out in Hospital Universiti Sains
Malaysia, Kubang Kerian, Kelantan, under the Department of Neurosciences. A total of 157 patients,
from all age groups, who were diagnosed with TBI were enrolled from June 2007 to December 2007.
They were followed-up for 12 months until death or their first post-traumatic seizure. Survival
analysis with Kaplan–Meier curves and Cox proportional hazards regression was performed.
Results: A total of 11 (7.0%) of the patients developed early post-traumatic seizures. The risk
factors for early post-traumatic seizures were young age (P = 0.021, 95% CI 0.806 to 0.982) and
intubated patients (P = 0.029, 95% CI 1.194 to 25.913). The incidence of early post-traumatic seizures
in the local population was 7.0%.
Conclusion: The incidence of early post-traumatic seizures in the local population of Kelantan
and Terengganu is comparable to the incidences reported elsewhere. Younger as well as intubated
patients were at a higher risk of developing this condition. It may be necessary to give antiepileptic
prophylaxis because any seizure could adversely affect morbidity and mortality. However, the study
showed that antiepileptic drug was not beneficial in preventing late post-traumatic seizures, but may
have a role in preventing early seizures.
- Full text:W020151022508762848576.pdf
