| Objective:Traumatic brain injury (TBI) increases the risk of posttraumatic epilepsy (PTE). The purpose of this study was to investigate the incidence of TBI, the incidence of posttraumatic seizure and epilepsy, the seizure type of epilepsy, risk factors of epilepsy, treatment and the quality of life in a hospital of Tianjin from September 2004 to September 2007.Content:(1) To investigate the incidence of TBI; (2) To investigate the incidence of epileptic seizures and epilepsy after TBI; (3) To analysis the risk factors of PTE; (4) To analysis the seizure type of PTE; (5) To research the treatment of PTE; (6) To investigate the quality of life of the patients with PTE.Methods:(1) Retrospective study:the TBI cases discharged after the improvement from September 2004 to September 2007 were investigated retrospectively. We filled the《hospitalized patients with traumatic brain injury retrospective questionnaire》which include the general situation of patients, diagnosis and treatment of TBI, etc; (2) Follow-up:telephone follow-up and return visit. Patients diagnosed as TBI by our hospital and with complete data were followed up by telephone after 2～5 years. We filled the《follow-up questionnaire in patients with traumatic brain injury》, which including the general situation of patients, with or without epileptic seizure, seizure type, seizure frequency, treatment and daily life and so on.Results:(1) The high risk age of TBI was 21～50 years old. The main reason was traffic accident injuries (53.5%), combat (25.9%) and fall (15.6%). Common clinical manifestations were headache (87.1%), disturbance of consciousness (36.8%), vomiting (27.9%) and limb convulsion (0.7%). (2) 49.5% of patients after injury with intracranial imaging examinations showed varying degrees of abnormal, including skull fracture (34.8%), subarachnoid hemorrhage (30.1%), cerebral contusion, laceration (25.4%), et al. Mild traumatic brain injury showed the highest incidence in all ages; severe TBI high incidence age was 11～40 years old. (3) 27.2% of patients received surgical treatment, the common surgical method was puncture and external drainage (27.2%), hematoma (9.3%) and decompressive craniectomy (8.2%). (4) The incidence of PTE was 4.8%; the age of high incidence was 61～70 years old (12.5%), 51～60 years old (10.7%), less than 10 years old (6.7%). Patients with PTE showed simple partial seizure in 14 cases, complex partial seizure in 8 cases, simple or complex partial seizure with secondary GTCS in 76 cases. And acute onset in 7 cases, early onset in 5 cases, late onset in 86 cases,40 cases occurred in more than six months after trauma. (5) Serious injury, old age, cortical injury, subarachnoid hemorrhage, many surgical treatment and appeared limb convulsion after injury would increase the incidence of PTE(p<0.05). In this study, the incidence of PTE had no significant relations with the nature of injury (open/closed), gender and the treatment in time or not. (6) More patients with PTE in Tianjin area went to 3 A-level hospitals for medical treatment than foreign patients (χ2=4.397, p<0.05).22.4% of patients had delayed treatment,14.3% of patients had delayed diagnosis. The commen treatments included western therapeutic (100%), traditional Chinese medicine (8.0%), prescriptions (8.0%), acupuncture treatment (4.0%) and surgical treatment (2.0%). The commen antiepileptic included depakine (42.0%), tegretol (40.0%) and phenytoin (30.0%).42.0% of patients accepted single-drug treatment, and 58.0% of patients accepted combination therapy. (7) The incidence of cognitive impairment, memory loss, computing power drops was higher in patients with PTE than non-PTE patients (p<0.05). The activities of daily living in patients with PTE decreased significantly(χ2=496.908, p<0.05). There was a high incidence of personality change after injury in patients with PTE(χ2=81.331, p<0.05).Conclusion:The incidence and cause of TBI is correlation with age. The risk of posttraumatic seizure and epilepsy is correlation with the severity of TBI, injury age, injury location, imaging findings, treatment methods and clinical manifestations after injury. The major type of epileptic seizure is partial onset seizure with secondary GTCS. The quality of life of patients with PTE decreases significantly. There exists mora in the diagnosis and treatment of PTE. It is important in the prevention and treatment of PTE that to investigate the status of incidence and treatment of PTE. |
PDF Full Text Request