Abstracts

Rationale: Head trauma in children is the one of causes in epilepsy. The incidence of seizure after head trauma varies with the severity of brain injury, neurologic, neuroradiologic findings, and age. But for epilepsy after head trauma it is not well known. We would like to know the incidence and the influencing factors of epilepsy after head trauma in children. Methods: We reviewed retrospectively the medical records of 358 children with head trauma under 15 year old, who were admitted to the Wonju Christian Hospital from January, 2000 to December, 2005. The patients were divided non-seizure (NS) and seizure (S) after head trauma groups. In the S group, persistent seizures patients over 1 month after head trauma were defined epilepsy (E) group. We compared the characteristics of these three groups by severity of brain injury and other clinical variables such as age, sex, type of seizure, Grasgow Coma Scale (GCS)score, neurologic and neuroradiologic findings. Results: The mean age was NS; 6.38 3.95 years, S; 4.90 3.81 years, and E; 5.48 3.01. The sex ratio (male:female) was NS; 1.8:1, S; 2:1, E; 6:1. The incidences of seizure and epilepsy after head trauma were 7.0% and 2.0%. The influencing factors of seizures after head trauma were abnormal initial neurologic findings such as hemiplegia and coma, duration of unconsciousness, GSC score under 12, and abnormal neuroimaging findings. But there was no different incidence rate by the severity of brain injury. The characteristics of E group were that the type of initial seizure was generalized tonic-clonic (85.7%); 57.1% had skull fracture; 71.4% had cerebral hemorrhage; 51.7% did brain operation; all patients showed abnormal neuroimaging findings of cerebral contusion. Conclusions: We concluded the incidence of epilepsy after head trauma was lower than expected. The influencing factors for seizures after head trauma were abnormal initial neurologic findings such as hemiplegia and coma, duration of unconsciousness, GCS score under 12, and abnormal neuroimaging findings. Even though a large population studies will be necessary in the future, it may be influenced by severe brain injury to develop the epilepsy after trauma.