{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T20:02:30Z","timestamp":1751400150533},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Of the 1.7 million traumatic brain injuries (TBIs) in the US, a third occur in patients under 14 years of age. The rate of posttraumatic epilepsy (PTE) may be as high as 19% after severe pediatric TBI, but the risk for seizures after mild TBI is unknown. Although the rate of seizures after mild TBI may be low, current practice is often driven by high clinical concern for posttraumatic seizures. In this study, the authors evaluated electroencephalography (EEG) results and antiepileptic drug (AED) use in a large cohort of children with mild TBI to estimate the incidence of posttraumatic seizures in this population.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Patients presenting to Children\u2019s Hospital of Atlanta for mild TBI from 2010 to 2013 were evaluated. Five thousand one hundred forty-eight patients with mild TBI were studied and divided into 3 groups: 4168 who were discharged from the emergency department, 868 who were admitted without neurosurgical intervention, and 112 who underwent neurosurgical procedures (craniotomy for hematoma evacuation or elevation of depressed skull fractures) but were discharged without an extended stay. Demographic information, CT characteristics, EEG reports, and prescriptions for AEDs were analyzed. Long-term follow-up was sought for all patients who underwent EEG. Correlation between EEG result and AED use was also evaluated.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>All patients underwent head CT, and admitted patients were more likely to have an abnormal study (p &lt; 0.0001). EEG evaluations were performed for less than 1.0% of patients in all 3 categories, without significant differences between groups (p = 0.97). Clinicians prescribed AEDs in less than 2.0% of patients for all groups, without significant differences between groups (p = 0.094). Even fewer children continue to see a neurologist for long-term seizure management. The EEG result had good negative predictive value, but only an abnormal EEG reading that was diagnostic of seizures correlated significantly with AED prescription (p = 0.04).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>EEG utilization and AED prescription was low in all 3 groups, indicating that seizures following mild TBI are likely rare events. EEG has good negative predictive value for patients who did not receive AEDs, but has poorer positive predictive value for AED use.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.7.peds14723","type":"journal-article","created":{"date-parts":[[2015,11,27]],"date-time":"2015-11-27T14:58:51Z","timestamp":1448636331000},"page":"476-482","source":"Crossref","is-referenced-by-count":15,"title":["Mild traumatic brain injury in children is associated with a low risk for posttraumatic seizures"],"prefix":"10.3171","volume":"17","author":[{"given":"Anna L.","family":"Huguenard","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Emory University; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Sarda","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery Associates at Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith","family":"Capasse","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery Associates at Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Reisner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University; and"},{"name":"Pediatric Neurosurgery Associates at Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua J.","family":"Chern","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University; and"},{"name":"Pediatric Neurosurgery Associates at Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-peds14723","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1212\/WNL.30.7.683","article-title":"Seizures after head trauma: a population study","volume":"30","author":"Annegers","year":"1980"},{"key":"b2-peds14723","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1056\/NEJM199801013380104","article-title":"A population-based study of seizures after traumatic brain injuries","volume":"338","author":"Annegers","year":"1998"},{"key":"b3-peds14723","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1007\/s00381-012-1863-0","article-title":"Posttraumatic seizures in children with severe traumatic brain injury","volume":"28","author":"Arango","year":"2012"},{"key":"b4-peds14723","series-title":"J Trauma Acute Care Surg","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1097\/TA.0b013e3182aafd15","article-title":"More harm than good: antiseizure prophylaxis after traumatic brain injury does not decrease seizure rates but may inhibit functional recovery","volume":"76","author":"Bhullar","year":"2014"},{"key":"b5-peds14723","series-title":"CDC\u2019s Injury Center: Traumatic Brain Injury","article-title":"Rates of TBI-related emergency department visits, hospitalizations, and deaths-United States","author":"Centers for Disease Control and Prevention","year":"2001"},{"key":"b6-peds14723","series-title":"J Commun Disord","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/S0021-9924(00)00029-0","article-title":"Discussion of developmental plasticity: factors affecting cognitive outcome after pediatric traumatic brain injury","volume":"33","author":"Chapman","year":"2000"},{"key":"b7-peds14723","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"525","DOI":"10.3171\/2014.2.PEDS13493","article-title":"Return to system within 30 days of discharge following pediatric shunt surgery","volume":"13","author":"Chern","year":"2014"},{"key":"b8-peds14723","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"306","DOI":"10.3171\/2014.6.PEDS13682","article-title":"Utility of surveillance imaging after minor blunt head trauma","volume":"14","author":"Chern","year":"2014"},{"key":"b9-peds14723","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1212\/WNL.33.4.400","article-title":"Local cerebral metabolism during partial seizures","volume":"33","author":"Engel","year":"1983"},{"key":"b10-peds14723","series-title":"Traumatic Brain Injury in the United States. Emergency Department Visits, Hospitalizations, and Deaths, 2002\u20132006","author":"Faul","year":"2010"},{"key":"b11-peds14723","series-title":"Eur J Paediatr Neurol","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.ejpn.2014.01.011","article-title":"Early classification of childhood focal idiopathic epilepsies: is it possible at the first seizure?","volume":"18","author":"Gaggero","year":"2014"},{"key":"b12-peds14723","series-title":"Semin Pediatr Neurol","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.spen.2006.09.005","article-title":"Pediatric minor traumatic brain injury","volume":"13","author":"Gordon","year":"2006"},{"key":"b13-peds14723","series-title":"J Trauma Acute Care Surg","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1097\/TA.0000000000000155","article-title":"Management of children with mild traumatic brain injury and intracranial 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