Modeling of post-traumatic epilepsy and experimental research aimed at its prevention

Research on the prevention of post-traumatic epilepsy (PTE) has seen remarkable advances regarding its physiopathology in recent years. From the search for biomarkers that might be used to indicate individual susceptibility to the development of new animal models and the investigation of new drugs, a great deal of knowledge has been amassed. Various groups have concentrated efforts in generating new animal models of traumatic brain injury (TBI) in an attempt to provide the means to further produce knowledge on the subject. Here we forward the hypothesis that restricting the search of biomarkers and of new drugs to prevent PTE by using only a limited set of TBI models might hamper the understanding of this relevant and yet not preventable medical condition.

Progress in Research on Biomarkers of Post-Traumatic Epilepsy / 法医学杂志

Post traumatic epilepsy （PTE） is a serious complication of traumatic brain injury and a difficult problem in forensic justice practice. In recent years, many biomarkers have been applied to the diagnosis, treatment and prognosis of injuries and diseases. There have been many studies on the biomarkers of PTE in the field of epilepsy. This paper reviews the progress in research on biomarkers of PTE in recent years in order to provide reference for the forensic identification of PTE.

Clinical analysis on risk factors and prognosis of early post-traumatic epilepsy / Análise clínica de fatores de risco e prognóstico da epilepsia pós-traumática precoce

ABSTRACT Objective To analyze the risk factors and prognosis related to early post-traumatic epilepsy (EPTE). Methods One hundred and eighty-six patients with traumatic brain injury were enrolled. Their full clinical data were collected. Single factor analysis and logistic regression analysis of risk factors related to EPTE were performed. The prognosis of patients was determined. Results Single factor analysis showed that there were significant differences of age (p = 0.011), epilepsy history (p < 0.001), injury site (p = 0.004), injury type (p < 0.001) and injury degree (p < 0.001) between the EPTE group (40 patients) and non-EPTE group (146 patients). Logistic regression analysis showed that the injury site, injury type and injury degree were the main risk factors for EPTE. The odds ratio values of injury site, injury type and injury degree were 1.977 (1.473-2.679), 2.096 (1.543-2.842) and 2.376 (1.864-3.609), respectively. The logistic regression equation was P = Exp (-1.473 + 0.698 × injury site + 0.717 × injury type + 0.935 × injury degree). The sensitivity and specificity of injury site, injury type and injury degree for predicting EPTE were 79.2% and 80.5%, 78.9% and 85.7% and 84.2% and 81.0%, respectively. The analysis of prognosis showed that the Glasgow Outcome Scale/Activity of Daily Living Scale scores in the EPTE group were significantly lower than those in non-EPTE group (p < 0.05). Conclusions Injury site, injury type and injury degree are the main risk factors for EPTE. The prognosis of patients with traumatic brain injury can be affected by EPTE.

RESUMO Objetivo Analisar os fatores de risco e prognóstico relacionados à epilepsia pós-traumática precoce (EPTE). Métodos Cento e oitenta e seis pacientes com lesão cerebral traumática foram incluídos. Seus dados clínicos completos foram coletados. A análise fatorial única e a análise de regressão logística dos fatores de risco relacionados à EPTE foram realizadas. O prognóstico dos pacientes foi observado. Resultados A análise fatorial única mostrou que houve diferenças significativas de idade (p = 0,011), história de epilepsia (p < 0,001), local da lesão (p = 0,004), tipo de lesão (p < 0,001) e grau de lesão (p < 0,001) entre o grupo EPTE (40 casos) e o grupo não-EPTE (146 casos), respectivamente. A análise de regressão logística mostrou que o local da lesão, tipo de lesão e grau de lesão foram os principais fatores de risco para EPTE. Os valores de razões de chance do local da lesão, tipo de lesão e grau de lesão foram 1.977 (1.473-2.679), 2.096 (1.543-2.842) e 2.376 (1.864-3.609), respectivamente. A equação de regressão logística foi P = Exp (-1,473 + 0,698 × local de lesão + 0,717 × tipo de lesão + 0,935 × grau de lesão). A sensibilidade e especificidade do local da lesão, tipo de lesão e grau de lesão para a predição da EPTE foram de 79,2% e 80,5%, 78,9% e 85,7% e 84,2% e 81,0%, respectivamente. A análise do prognóstico mostrou que o escore da Escala de Desfechos de Glasgow / Atividade de Vida Diária no grupo EPTE foi significativamente menor do que no grupo não-EPTE (P <0,05). Conclusões O local da lesão, tipo de lesão e grau de lesão são os principais fatores de risco para EPTE. A EPTE pode afetar o prognóstico de pacientes com lesão cerebral traumática.

Disability evaluation of 204 cases of children with brain injury in road traffic accidents / 法医学杂志

OBJECTIVE@#To study the types, characteristics and common complications as well as disability assessment for the children with craniocerebral injury in the road traffic accidents.@*METHODS@#Data from 204 cases of children with cranio-injury in road traffic accidents were collected and were statistically analyzed according to the location injured, complication, the type of complication and the severity of disability.@*RESULTS@#There were 64 cases of simple diffuse primary craniocerebral injury, 80 cases of simple local primary cranio-injury, 24 cases of diffuse secondary craniocerebral injury and 36 cases of local secondary cranio-injury. The main complications included traumatic epilepsy (14, 6.9%), traumatic cerebral infarction (9, 4.4%), traumatic hydrocephalus (7, 3.4%) and traumatic mental disorder (5, 2.5%).@*CONCLUSION@#Among the children with cranio-injury due to road traffic accidents, simple primary cranio-injury was the most common result, whereas the traumatic epilepsy and traumatic cerebral infarction were the major types of complications. The assessment criteria for body impairment of the children with craniocerebral injury in the road traffic accidents should be broadened accordingly, with addition of certain specific items for children.

The forensic determination of post-traumatic epilepsy in 21 patients / 法医学杂志

UNLABELLED@#To evaluate the forensic determination of post cerebral traumatic epilepsy.@*METHODS@#In 21 patients, traumatic history and previous history were analysied combined with the demonstrations of electroencephalogram(EEG), X-ray, CT and MRI.@*RESULTS@#Post-traumatic epilepsy, manily in late stage, usually occurred following serious cerebral trauma. The type of traumatic epilepsy was determined by the traumatic location and extent. Abnormal epileptic wave in scalp EEG and 24 h dynamic EEG and medical image examinations were helpful for qualitative analysis.@*CONCLUSION@#The forensic determination of post traumatic epilepsy must be on the basis of traumatic and previous history combined with EEG, CT and MRI analysis.

Epilepsia Traumática Temprana en Niños: Epidemiología y Pronóstico Inmediato / Early traumatic epilepsy in children: epidemiology and inmediate pronostic

El presente trabajo tiene como objetivo analizar 110 casos de Epilepsia Traumática Temprana (ETT) en niños hospitalizados en el Servicio de Neurocirugía del Instituto Nacional de Salud del Niño entre enero de 1982 a diciembre de 1986. Los casos correspondieron al 7.3% de 1448 niños hospitalizados con traumatismo craneoencefálico. Se usó el método descriptivo retrospectivo.El 65.52% presentaron la edad de 3 a 10 años. El 63.60% fueron de sexo masculino. La etiología predominante correspondió a caídas de altura y accidentes de transito. Los factores clínicos más importantes asociados a esta entidad fueron: pérdida de conciencia mayor de 24 horas, 35.41%; los signos focales 13.64%; hematoma intracraneano 4.55% y lesiones de duramadre, 1.85%. Además el 25.45% presentaron una lesión trivial craneoencefálica. El 23.64% presentó fracturas craneales. El 86.36% presentaron su primera crisis dentro de las primeras 24 horas post-traumatismo encéfalo craneano. No se encontró diferencia en el tipo de convulsiones; focal, focal-generalizada y generalizada. El 5.76% fallecieron.