Outcome of early posttraumatic seizure: An experience in Nigeria

Purpose: To determine the frequency, causes, risk factors and outcome following early posttraumatic seizure. Methods: A retrospective analysis of age, sex, mechanism of injury, type and onset of unprovoked seizure occurring within one week of injury, admission coma score, and Glasgow outcome score in patients with nonpenetrating head injury. Results: Eighty six (10.2%) of 845 head injured patients developed early posttraumatic seizure. They were 55 (64%) children and 31 (36%) older subjects. The seizure was partial in 35% but generalized in 65% of cases. The frequency of seizure increased significantly with decreasing age (p=0.00002) and coma score (p=0.00009) in the seizure group and also in relation to the entire sample (n=845) of head injured patients (p=0.00000). Traffic accident was the leading cause of head injuries (58%), while fall from height (32.5%), domestic injuries (4.2%) and non-penetrating assault (3.5%) were miscellaneous causes. Pedestrian vehicular injury and falls were the commonest mechanisms of injury in children, while older patients were most frequently involved as passengers in auto-crash. Early posttraumatic seizure worsened outcome of head injury, the case mortality rate being 27.9% and 19.2% in patients with and without posttraumatic seizure respectively. Conclusions: The frequency of early posttraumatic seizure in our setting is 10.2%. This varies significantly with patients' age and initial coma score.