Mikkonen, ED, Skrifvars, MB, Reinikainen, M, et al. Posttraumatic epilepsy in intensive care unit–treated pediatric traumatic brain injury patients. Epilepsia. 2020; 61: 693– 701. https://doi.org/10.1111/epi.16483
Posttraumatic epilepsy in intensive care unit–treated pediatric traumatic brain injury patients
|Author:||Mikkonen, Era D.1,2; Skrifvars, Markus B.3; Reinikainen, Matti4;|
1Department of Anesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital & University of Helsinki, Helsinki, Finland
2Finland Department of Emergency Care and Services, Helsinki University Hospital & University of Helsinki, Helsinki, Finland
3Department of Emergency Care and Services, Helsinki University Hospital & University of Helsinki, Helsinki, Finland
4Department of Anaesthesiology and Intensive Care, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
5Department of Intensive Care, Turku University Hospital and University of Turku, Turku, Finland
6Emergency Medical Services, Department of Intensive Care, Tampere University Hospital & Tampere University, Tampere, Finland
7Division of Intensive Care, Medical Research Center Oulu MRC, Oulu University Hospital, Research Group of Anesthesiology, Surgery and Intensive Care Medicine, University of Oulu, Oulu, Finland
8Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
|Online Access:||PDF Full Text (PDF, 0.6 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2020060941232
John Wiley & Sons,
|Publish Date:|| 2020-06-09
Objective: Posttraumatic epilepsy (PTE) is a well‐described complication of traumatic brain injury (TBI). The majority of the available data regarding PTE stem from the adult population. Our aim was to identify the clinical and radiological risk factors associated with PTE in a pediatric TBI population treated in an intensive care unit (ICU).
Methods: We used the Finnish Intensive Care Consortium database to identify pediatric (<18 years) TBI patients treated in four academic university hospital ICUs in Finland between 2003 and 2013. Our primary outcome was the development of PTE, defined as the need for oral antiepileptic medication in patients alive at 6 months. We assessed the risk factors associated with PTE using multivariable logistic regression modeling.
Results: Of the 290 patients included in the study, 59 (20%) developed PTE. Median age was 15 years (interquartile range [IQR] 13‐17), and 80% had an admission Glasgow Coma Scale (GCS) score ≤12. Major risk factors for developing PTE were age (adjusted odds ratio [OR] 1.08, 95% confidence interval [CI] 1.00‐1.16), obliterated suprasellar cisterns (OR 6.53, 95% CI 1.95‐21.81), and an admission GCS score of 9‐12 in comparison to a GCS score of 13‐15 (OR 2.88, 95% CI 1.24‐6.69).
Significance: We showed that PTE is a common long‐term complication after ICU‐treated pediatric TBI. Higher age, moderate injury severity, obliterated suprasellar cisterns, seizures during ICU stay, and surgical treatment are associated with an increased risk of PTE. Further studies are needed to identify strategies to decrease the risk of PTE.
|Pages:||693 - 701|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
3124 Neurology and psychiatry
We would like to thank Medicinska Understödsföreningen Liv & Hälsa and Finska Läkaresällskapet for the funding of this study.
© 2020 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.