• Traumatic brain injury;
  • Seizures;
  • Glucocorticoids;
  • Prevention

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.