Investigation of post–traumatic seizures in patients with severe traumatic brain injury: Analysis of Japan Neurotrauma Data Bank Project 2015

Abstract

Background: Seizures are recognized as an important complication of traumatic brain injury (TBI). However, post–traumatic seizures and –epilepsy, –convulsions are complicated in their terms. We analyzed present situation of post–traumatic seizures from the data of the Project 2015 in the Japan Neurotrauma Data Bank (JNTDB2015).

Patients and methods: 1,344 patients were included in this study. Seizure was observed in 139 patients (10.3%). Seizure happened within 24 hours after the trauma in 51 patients (3.8%), within a week in 52 patients (3.9%).

Results: A risk factor of post–traumatic seizures is the presence of evacuated mass lesion on CT image (p<0.05) in this study. Antiepileptic drugs (AED) are used in 363 patients (27%). AEDs were used in 128 patients (96%) of patients with seizures, and were used in 236 patients (19.5%) of patients without seizures. No relationship was observed between the outcome of patients and the pres­ence of post–traumatic seizures.

Discussion and conclusion: We analyzed post–traumatic seizures using JNTDB 2015. Post–traumatic seizure was ob­served in 10% patients. However, AEDs were rarely used despite of the recommendation by guideline. Furthermore, electroencephalogram examination rate was very low. As the prevention and treatment of seizures are important issues in the management of severe head trauma, we should plan the prospective multicenter studies for the standardization of the treatment strategy in our society. In addition, it will be necessary to review the evaluation items for the future databank projects.