Electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head trauma
Background: The clinical presentations of abusive head trauma can abruptly worsen, so the occurrence of seizures and changes of EEG can be variable according to patients’ conditions. Since the changes of EEG background waves reflect the cortical function of children, we aimed to find out whether the...
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Elsevier
2024-05-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957223001870 |
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| author | Cheng-Che Chou Ju-Yin Hou I-Jun Chou Shih-Yun Lan Shu-Sing Kong Man-Hsu Huang Yu-Chieh Weng Yi-Yu Lin Cheng-Yen Kuo Meng-Ying Hsieh Min-Liang Chou Po-Cheng Hung Huei-Shyong Wang Kuang-Lin Lin Yi-Shan Wang Jainn-Jim Lin |
| author_facet | Cheng-Che Chou Ju-Yin Hou I-Jun Chou Shih-Yun Lan Shu-Sing Kong Man-Hsu Huang Yu-Chieh Weng Yi-Yu Lin Cheng-Yen Kuo Meng-Ying Hsieh Min-Liang Chou Po-Cheng Hung Huei-Shyong Wang Kuang-Lin Lin Yi-Shan Wang Jainn-Jim Lin |
| author_sort | Cheng-Che Chou |
| collection | DOAJ |
| description | Background: The clinical presentations of abusive head trauma can abruptly worsen, so the occurrence of seizures and changes of EEG can be variable according to patients’ conditions. Since the changes of EEG background waves reflect the cortical function of children, we aimed to find out whether the timing of EEG background, epileptiform discharges and seizure patterns were associated with the outcomes of patients with AHT. Material and methods: Using seizure type and acute stage electroencephalographic (EEG) characteristics to assess adverse neurological outcomes in children with seizures secondary to abusive head trauma (AHT). Children who were hospitalized with AHT at a tertiary referral hospital from October 2000 to April 2010 were evaluated retrospectively. A total of 50 children below 6 years of age admitted due to AHT were included. KOSCHI outcome scale was used to evaluate the primary outcome and neurological impairment was used as secondary outcome after 6 months discharge. Results: Children with apnea, cardiac arrest, reverse blood flow and skull fracture in clinic had a higher mortality rate even in the no-seizure group (3/5 [60%] vs. 3/45 [6.7%], odds ratio [OR] = 11; 95% CI = 2.3–52; p = 0.025). Seizure occurrence reduced mostly at the second day after admission in seizure groups; but children with persistent seizures for 1 week showed poor neurological outcomes. The occurrence of initial seizure was frequency associated with younger age; focal seizure, diffuse cortical dysfunction in acute-stage EEG, and low Glasgow Coma Scale (GCS) score were significantly related to poor outcomes after 6 months. Diffuse cortical dysfunction was also associated with motor, speech, and cognitive dysfunction. Conclusions: Diffuse cortical dysfunction in acute-stage EEG combined with low GCS score and focal seizure may related to poor outcomes and neurological dysfunctions in children with AHT. |
| format | Article |
| id | doaj-art-e7e1d4474eb94d7c8cd6cd2e625b1a98 |
| institution | DOAJ |
| issn | 1875-9572 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-e7e1d4474eb94d7c8cd6cd2e625b1a982025-08-20T03:21:02ZengElsevierPediatrics and Neonatology1875-95722024-05-0165324925410.1016/j.pedneo.2023.05.012Electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head traumaCheng-Che Chou0Ju-Yin Hou1I-Jun Chou2Shih-Yun Lan3Shu-Sing Kong4Man-Hsu Huang5Yu-Chieh Weng6Yi-Yu Lin7Cheng-Yen Kuo8Meng-Ying Hsieh9Min-Liang Chou10Po-Cheng Hung11Huei-Shyong Wang12Kuang-Lin Lin13Yi-Shan Wang14Jainn-Jim Lin15Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan; Ph.D. Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, New Taipei City Hospital, New Taipei City, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Shuang Ho Hospital, New Taipei City, TaiwanDepartment of Pathology, Taipei Medical University Shuang Ho Hospital, New Taipei City, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, Taiwan; Corresponding author. 33305, No. 5, Fuxing St., Guishan Dist, Taoyuan, Taiwan.Background: The clinical presentations of abusive head trauma can abruptly worsen, so the occurrence of seizures and changes of EEG can be variable according to patients’ conditions. Since the changes of EEG background waves reflect the cortical function of children, we aimed to find out whether the timing of EEG background, epileptiform discharges and seizure patterns were associated with the outcomes of patients with AHT. Material and methods: Using seizure type and acute stage electroencephalographic (EEG) characteristics to assess adverse neurological outcomes in children with seizures secondary to abusive head trauma (AHT). Children who were hospitalized with AHT at a tertiary referral hospital from October 2000 to April 2010 were evaluated retrospectively. A total of 50 children below 6 years of age admitted due to AHT were included. KOSCHI outcome scale was used to evaluate the primary outcome and neurological impairment was used as secondary outcome after 6 months discharge. Results: Children with apnea, cardiac arrest, reverse blood flow and skull fracture in clinic had a higher mortality rate even in the no-seizure group (3/5 [60%] vs. 3/45 [6.7%], odds ratio [OR] = 11; 95% CI = 2.3–52; p = 0.025). Seizure occurrence reduced mostly at the second day after admission in seizure groups; but children with persistent seizures for 1 week showed poor neurological outcomes. The occurrence of initial seizure was frequency associated with younger age; focal seizure, diffuse cortical dysfunction in acute-stage EEG, and low Glasgow Coma Scale (GCS) score were significantly related to poor outcomes after 6 months. Diffuse cortical dysfunction was also associated with motor, speech, and cognitive dysfunction. Conclusions: Diffuse cortical dysfunction in acute-stage EEG combined with low GCS score and focal seizure may related to poor outcomes and neurological dysfunctions in children with AHT.http://www.sciencedirect.com/science/article/pii/S1875957223001870Abusive head traumaBrain injuryChild abuseElectroencephalographyOutcomeSeizure |
| spellingShingle | Cheng-Che Chou Ju-Yin Hou I-Jun Chou Shih-Yun Lan Shu-Sing Kong Man-Hsu Huang Yu-Chieh Weng Yi-Yu Lin Cheng-Yen Kuo Meng-Ying Hsieh Min-Liang Chou Po-Cheng Hung Huei-Shyong Wang Kuang-Lin Lin Yi-Shan Wang Jainn-Jim Lin Electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head trauma Pediatrics and Neonatology Abusive head trauma Brain injury Child abuse Electroencephalography Outcome Seizure |
| title | Electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head trauma |
| title_full | Electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head trauma |
| title_fullStr | Electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head trauma |
| title_full_unstemmed | Electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head trauma |
| title_short | Electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head trauma |
| title_sort | electroencephalogram pattern predicting neurological outcomes of children with seizures secondary to abusive head trauma |
| topic | Abusive head trauma Brain injury Child abuse Electroencephalography Outcome Seizure |
| url | http://www.sciencedirect.com/science/article/pii/S1875957223001870 |
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