Does Glucocorticoid Administration Prevent Late Seizures after Head Injury?

Authors


Address correspondence and reprint requests to Dr. N.F. Watson at University of Washington Sleep Disorders Center, Box 359803, 325 Ninth Avenue, Seattle, WA 98104-2499, U.S.A. E-mail: nwatson@u.washington.edu

Abstract

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.

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