Department of Surgery, School of Medicine, College of Health Sciences, Makerere University Kampala, Uganda.
Department of Surgery, School of Medicine, College of Health Sciences, Makerere University Kampala, Uganda.
Epilepsy Behav. 2024 Mar;152:109693. doi: 10.1016/j.yebeh.2024.109693. Epub 2024 Feb 17.
Post-traumatic seizures (PTS) are common among patients with depressed skull fractures (DSF). Understanding the burden of post traumatic seizures and the factors associated among adult patients with DSF is important to improve clinical care.
To determine the prevalence and factors associated with post-traumatic seizures among adult patients with DSF at Mulago National Referral hospital (MNRH).
A cross-sectional study was conducted among 333 study participants between March 2021 and February 2022. Socio-demographic, clinical laboratory factors and anti-seizure medications were collected using a study questionnaire. Data was analysed to determine the prevalence of PTS and factors associated with occurrence of PTS among patients with DSF.
The mean age (±SD) of study participants was 31.2, (±10.5) years, with a male to female ratio of 10.4:1. Nearly half of the study participants had attained secondary level of education, while 31.6 % (105) were peasants (subsistence farmers). The overall prevalence of PTS among DSF study participants was 16.2 % (54participants). Late presentation of PTS was the highest at 9.0 % (30) followed by early PTS at 3.9 % [13] and immediate PTS at 3.3 % [11]. Moderate Glasgow coma score (GCS: 9-13), p < 0.015, severe traumatic brain injury (GCS: 3-8), p < 0.026 at the time of admission and midline brain shift (≥5mm), p < 0.009 were associated with PTS. Phenytoin (94.3 %) was the most commonly used ASM followed by phenobarbitone (1.4 %) and Valproate (1.1 %) among study participants.
Patients with moderate and severe traumatic brain injury and midline brain shift were associated with post traumatic seizures. Early identification and intervention may reduce the burden of posttraumatic seizures in this category of patients.
外伤性癫痫（PTS）在颅骨凹陷性骨折（DSF）患者中很常见。了解成人 DSF 患者 PTS 的发生率及相关因素对于改善临床护理至关重要。
在穆拉戈国家转诊医院（MNRH）确定颅骨凹陷性骨折成年患者 PTS 的发生率及相关因素。
2021 年 3 月至 2022 年 2 月期间对 333 名研究参与者进行了横断面研究。使用研究问卷收集社会人口统计学、临床实验室因素和抗癫痫药物的数据。对数据进行分析，以确定颅骨凹陷性骨折患者 PTS 的发生率及相关因素。
研究参与者的平均年龄（±SD）为 31.2，（±10.5）岁，男女比例为 10.4:1。近一半的研究参与者接受过中学教育，而 31.6%（105）是农民（自给自足的农民）。颅骨凹陷性骨折研究参与者中 PTS 的总体发生率为 16.2%（54 名参与者）。PTS 的迟发性发作率最高，为 9.0%（30 人），其次是早期 PTS 为 3.9%[13]，即刻 PTS 为 3.3%[11]。入院时格拉斯哥昏迷评分（GCS：9-13），p<0.015，严重创伤性脑损伤（GCS：3-8），p<0.026，以及中线脑移位（≥5mm），p<0.009 与 PTS 相关。苯妥英（94.3%）是研究参与者中最常用的 ASM，其次是苯巴比妥（1.4%）和丙戊酸钠（1.1%）。
中度和重度创伤性脑损伤及中线脑移位与 PTS 相关。早期识别和干预可能会降低此类患者 PTS 的负担。
