Factors influencing the occurrence of post-traumatic seizures in 92 of 937 children with head injuries (9.8%) were studied in the Division of Neurosurgery, Children’s Memorial Hospital, Chicago, Illinois. Seizures were generalized in 64% and focal in 28%. They occurred within 24 hours after injury in 95% and within 7 days in 98%. The injury was caused by a fall in 60%. Children with a severe head injury (Glasgow Coma Scale ≤ 8) had a 7 times higher incidence of seizures than those with minor trauma. Those with CT evidence of diffuse cerebral edema or subdural hematoma had the highest incidence of seizures. Prophylactic use of anticonvulsants was recommended in children with diffuse cerebral edema, subdural hematoma, open depressed skull fracture, or severe head injuries. [1]

COMMENT. Unfortunately, the duration of prophylactic anticonvulsant therapy was not addressed in this report, although the follow-up period was 7 months to 6 years. In a previous study at the Mayo Clinic involving 2747 patients of all ages with head injury, early seizures occurred in 2.1%. The risks of post-traumatic seizures after severe injury were 7.1% within 1 year and 11.5% in 5 years, after moderate injury 0.7% and 1.6%, and after mild injury 0.1% and 0.6%. Children were at a greater risk for early seizures after severe trauma than adults, but late seizures in children were less frequent and had no relation to the occurrence of early seizures. Mild head trauma in both children and adults did not cause epilepsy. [2]