1. Prevalence of epileptic and nonepileptic events after pediatric traumatic brain injury
- Author
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Joyce H. Matsumoto, David L. McArthur, Christopher C. Giza, Sue Yudovin, Rochelle Caplan, and Marcy Forgey
- Subjects
medicine.medical_specialty ,Pediatrics ,Adolescent ,Databases, Factual ,Traumatic brain injury ,Poison control ,Cohort Studies ,Behavioral Neuroscience ,Epilepsy ,Seizures ,Prevalence ,medicine ,Humans ,Child ,Psychiatry ,Retrospective Studies ,Chi-Square Distribution ,business.industry ,Age Factors ,Electroencephalography ,Sequela ,Retrospective cohort study ,Cortical dysplasia ,Epilepsy, Post-Traumatic ,medicine.disease ,Neurology ,Brain Injuries ,Child, Preschool ,Etiology ,Neurology (clinical) ,business ,Psychopathology - Abstract
Though posttraumatic epilepsy (PTE) is a prominent sequela of traumatic brain injury (TBI), other nonepileptic phenomena also warrant consideration. Within two UCLA pediatric TBI cohorts, we categorized five spell types: 1) PTE; 2) Epilepsy with other potential etiologies (cortical dysplasia, primary generalized); 3) Psychopathology; 4) Behavior misinterpreted as seizures; and 5) Other neurologic events. The two cohort subsets differed slightly in injury severity, but they were otherwise similar. Overall, PTE occurred in 40%, other epilepsy etiologies in 14%, and nonepileptic spells collectively in 46%. Among children with spells, PTE was associated with severe TBI (p=0.001), whereas psychopathology (p=0.014) and epilepsy with other etiologies (p=0.006) were associated with milder TBI severity. Posttraumatic epilepsy (p=0.002) and misinterpreted behavior (p=0.049) occurred with younger injury age. Psychopathology (p=0.020) and other neurologic events (p=0.002) occurred with older injury age. In evaluating possible PTE, clinicians should maintain a broad differential diagnosis to prevent misdiagnosis and inappropriate treatment.
- Published
- 2013
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