Post-traumatic seizures are dangerous in the first week after a severe traumatic brain injury. Currently, the recommended guideline for a child at high risk for early post-traumatic seizures is to use an anti-epileptic drug for prevention. But, it can be difficult to predict those at risk, and there is no consensus on timing or dosage.
Recent research has uncovered the most consistent risk factors for early post-traumatic seizures. These are:
• Pre-hospital hypoxia
• Younger age (<2)
• Non-accidental trauma
• Severe TBI
• Impact seizure (within moments of injury)
• Subdural hematoma
These risk factors can help identify children who are at greatest risk of developing seizures, and who would benefit from an anti-epileptic. Although the researchers also found that use of an anti-epileptic protected their pediatric patients from early post-traumatic seizures, they do not yet have recommendations about timing and dosage.
Liesemer K, Bratton SL, Zebrack CM, Brockmeyer D, & Statler KD. Early post-traumatic seizures in moderate to severe pediatric traumatic brain injury: Rates, risk factors, and clinical features. Journal of Neurotrauma. (May 2011).