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177549

Medico-legal study of post-traumatic seizures and epilepsy in patients with traumatic brain injury in El Demerdash and Ain Shams Specialized Hospitals (2017 -2018)

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Last updated: 22 Jan 2023

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Abstract

Background: Traumatic brain injury (TBI) is one of the most leading causes of deaths and disability among youth worldwide. Post-traumatic seizures (PTS) and post-traumatic epilepsy (PTE) are important catastrophic complications of TBI. Epilepsy has important medico-legal aspects for both the patient and the physician. Aim of the study: to identify forms of post traumatic seizures (generalized, focal, or focal followed by secondary generalized), site of epileptic focus, nature of brain injury that caused their occurrence, risk factors for epilepsy occurrence and medico-legal importance of PTS. Methods: A prospective cross-sectional study was conducted including patients with PTS and PTE who presented to El Demerdash and Ain shams Specialized Hospitals during the study period. Data were collected from patients by a questionnaire and from clinical sheets. Patients were classified into three groups according to time of occurrence of PTS. Results: A total of 77 patients were included. Cases were mostly in the age group less than 45 years old. Male patients were more represented in the study (64.9%). Transportation injuries were the most prominent pattern of TBI followed by blunt trauma (29.9%), open head injuries (13%), fall from height (13%) and polytrauma (1.3%). The most common affected site was frontal area of the brain (51.9%) followed by temporal region (45.5%). Associated complications included intra-cranial hemorrhage (87%) and skull fracture (35.1%). Immediate seizures were recorded in 9.1 % of the studied patients compared to 26% with early PTS. Patients with late PTS were the majority accounting for 64.9% of study patients of whom 50% with late PTS from the start. Most cases experienced generalized seizures attacks (59.7%) followed by focal with secondary generalization seizures attacks in (27.3%) and the least were with focal seizures attacks (13.0%). EEG showed abnormal activity in (62.3%) of patients and normal activity in (37.7%). Conclusion: Post-traumatic seizures and epilepsy are an important well-known sequel of traumatic brain injury with important medico-legal aspects. Pattern of head injury and site of traumatic area are important risk factors in occurrence of PTS and EEG abnormal activity is an important predictor for occurrence of PTS as well.

DOI

10.21608/ajfm.2021.177549

Keywords

Traumatic brain injury, post-traumatic seizures, post-traumatic epilepsy, Medico-legal

Authors

First Name

Fatema

Last Name

Saleh

MiddleName

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Affiliation

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

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City

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Orcid

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First Name

Soha

Last Name

Ashry

MiddleName

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Affiliation

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

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City

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Orcid

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First Name

Ahmad

Last Name

El-Seginy

MiddleName

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Affiliation

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

Email

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City

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Orcid

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First Name

Hossam

Last Name

Afifiy

MiddleName

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Affiliation

Neurology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

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Orcid

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Volume

37

Article Issue

2

Related Issue

24869

Issue Date

2021-07-01

Receive Date

2021-06-14

Publish Date

2021-07-01

Page Start

43

Page End

48

Print ISSN

1687-1030

Online ISSN

2636-3356

Link

https://ajfm.journals.ekb.eg/article_177549.html

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https://ajfm.journals.ekb.eg/service?article_code=177549

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6

Type

Original Article

Type Code

665

Publication Type

Journal

Publication Title

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

Publication Link

https://ajfm.journals.ekb.eg/

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Article

Created At

22 Jan 2023