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Does Glucocorticoid Administration Prevent Late Seizures after Head Injury?
Author(s) -
Watson Nathaniel F.,
Barber Jason K.,
Doherty Michael J.,
Miller John W.,
Temkin Nancy R.
Publication year - 2004
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.0013-9580.2004.59403.x
Subject(s) - glucocorticoid , epilepsy , medicine , hazard ratio , odds ratio , traumatic brain injury , anesthesia , head injury , confidence interval , head trauma , pediatrics , surgery , psychiatry
Summary: Purpose: Preventing posttraumatic epilepsy has been a difficult challenge. In this study we evaluated the association between glucocorticoid administration after traumatic brain injury (TBI) and posttraumatic seizures. Methods: We examined a seizure‐prevention trial database of 404 patients with severe TBI for exposure to glucocorticoids in the early (<1 week) posttraumatic period. After controlling for seizure risk, we compared the odds of developing first and second late posttraumatic seizures between those that received glucocorticoids and those that did not. Results: Patients dosed with glucocorticoids within 1 day of their TBI were more likely to develop first late seizures than were those without [p = 0.04; hazard ratio = 1.74; 95% confidence interval (CI), 1.01–2.98]; whereas those receiving glucocorticoids ≥2 days after their injury had no similar association (p = 0.66; hazard ratio = 0.77; 95% CI, 0.23–2.56; p = 0.10 among the three groups). Receiving glucocorticoids within 1 day, or ≥2 days after TBI was not associated with second late seizure development. Conclusions: Glucocorticoid treatment after TBI is not associated with decreased late posttraumatic seizures, and early treatment is associated with increased seizure activity.