Structure of convulsive syndrome in patients with acute traumatic brain injury
Keywords:epileptic seizures, acute traumatic brain injury
Background. The study of the structure of seizures, the time of their occurrence, the relationship with the type of traumatic brain injury help identify a group of patients who will need urgent surgical correction of their condition, the preventive use of antiepileptic drugs, as well as clarifying the impact of seizures on the outcome. The purpose is to study the structure of epileptic seizures in acute traumatic brain injury for optimization of diagnostic measures and therapy in these patients. Materials and methods. Clinical and instrumental examination was carried out and the results of the treatment of 779 patients with traumatic brain injury who had seizures were analyzed. The average age of patients was 35.5 ± 7.8 years. Most of the observations were criminal trauma — 320 cases (41.1 %), 272 injuries were the result of road accidents (34.9 %), 109 patients were traumatized when they fell from own height (13.9 %), in 78 patients, causes of trauma were unknown (10.0 %). Results. Epileptic seizures occur in 8.4 % of patients with acute traumatic brain injury. 81.4 % of persons had immediate epileptic seizures, 15.7 % — early epileptic seizures and 2.9 % — late epileptic seizures. Immediate and early seizures were more likely partial, in the structure of late epileptic seizures in acute traumatic brain injury, generalized seizures dominated. 422 patients (54.2 %) underwent urgent surgery. Surgery after neurological treatment was performed in 232 patients (29.8 %), conservative therapy was carried out in 125 patients (16.0 %). Conclusions. Neurological examination of patients with epileptic seizures in acute traumatic brain injury must be supplemented by computed tomography, regardless of the level of impaired consciousness in the patient. Emergency surgical intervention in such patients aimed at eliminating progressive dislocation is often the main method of treatment. Therapy by antiepileptic drugs should be performed after the appearance of a single seizure within a short period of time; in the presence of unprovoked epileptic seizures and their recurrence, the administration of antiepileptic drugs should be prolonged.
Эпидемиология инвалидности вследствие черепно-мозговых травм в Украине / Н.К. Хобзей, Е.К. Педаченко, В.А. Голик, А.П. Гук, Н.А. Гондуленко // Україна. Здоров’я нації. — 2011. — № 3. — С. 30-34.
Полищук Н.Е., Педаченко Г.А., Полищук Л.Л. Алкогольная интоксикация в клинике неотложной нейрохирургии и неврологии. — К.: Книга плюс, 2000. — 204 с.
Уніфікований клінічний протокол первинної, екстреної, вторинної (спеціалізованої) та третинної (високоспеціалізованої) медичної допомоги «Епілепсії у дорослих». Затверджений наказом МОЗ України від 17.04.2014 № 276. — К., 2014. — 72 с. — Режим доступу: http://mtd.dec.gov.ua/images/dodatki/2014_276_Epilepsii/2014_276_YKPMD_epilepsiya_dorosli.pdf.
Хобзей Н.К., Педаченко Е.Г., Голик В.А., Гук А.П., Гондуленко Н.А. Эпидемиология инвалидности вследствие черепно-мозговых травм в Украине // Україна. Здоров’я нації. — 2011. — 3(19). — С. 30-4.
Frey L.C. Epidemiology of posttraumatic epilepsy: a critical review // Epilepsia. — 2003 Sep. — 44 (Suppl. 10). — 11-7. PMID:14511389. DOI: 10.1046/j.1528-1157.44.s10.4.x.
Glauser T., Ben-Menachem E., Bourgeois B., Cnaan A., Guerreiro C., Kälviäinen R. et al. ILAE subcommission on AED Guidelines. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes // Epilepsia. — 2013 Mar. — 54(3). — 551-63. doi: 10.1111/epi.12074. PMID: 23350722.
Temkin N.R. Risk factors for posttraumatic seizures in adults // Epilepsia. — 2003 Sep. — 44 (Suppl. 10). — 18-20. PMID:14511390. DOI: 10.1046/j.1528-1157.44.s10.6.x
Wang H., Xin T., Sun X., Wang S., Guo H., Holton-Burke C. et al. Post-traumatic seizures — a prospective, multicenter, large case study after head injury in China // Epilepsy Res. — 2013 Dec. — 107(3). — 272-8. DOI:10.1016/j.eplepsyres.2013.10.006. PMID:24239245.
Copyright (c) 2018 INTERNATIONAL NEUROLOGICAL JOURNAL
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.