Analysis of risk factors for the progression of post-traumatic epilepsy in children to drug-resistant epilepsy
Objective To investigate the risk factors for post-traumatic epilepsy(PTE)progressing from early drug-controlled status to drug-resistant epilepsy(DRE)in children.Methods A retrospective analysis was performed on the clinical data of 232 pediatric patients with post-traumatic epilepsy who were admitted to Department of Neurosurgery,the Second Affiliated Hospital of Chengdu Medical College,China National Nuclear Corporation 416 Hospital from January 2013 to June 2023.All patients were≤14 years old,and the follow-up time was＞2 years.Among them,54 cases were in the DRE group and 178 cases were in the non-DRE group.The differences in clinical data between the two groups were compared to screen for factors that influence the progression of PTE to DRE.The statistically significant differences between the two groups were included in the multivariate logistic regression model for analysis,and the independent risk factors that influenced the progression of PTE to DRE in children were screened.Results Compared with the non-DRE group,the DRE group had a higher proportion of children who were ≤7 years old,whose brain injury site was the temporal lobe,brain contusion and laceration,who did not undergo surgery within 24 hours after the injury,whose electroencephalogram showed epileptic discharges,and who had poor medication compliance(all P＜0.05).However,there were no statistically significant differences in the gender,cause of injury,open craniocerebral injury,or Glasgow Coma Score on admission between the two groups of children(all P＞0.05).Multivariate logistic regression analysis showed that age ≤7 years old(OR=7.27,95％CI:2.59-20.40),brain injury site in the temporal lobe(OR=13.06,95％CI:3.41-49.97),brain contusion(OR=5.36,95％CI:1.18-24.41)were associated with the progression of PTE to DRE(all P＜0.05).Conclusion Age ≤7 years old,temporal lobe damage,and brain contusion are independent risk factors for children with PTE to progress to DRE.
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