Electrographic Seizures and Antiseizure Medication Management in Pediatric Abusive Head Trauma: A Retrospective Cohort Study
Soheil M. Yazdi, Alexandria Melendez-Zaidi, Hannah Todd, Rebecca Schultz, Sharon Record, Medina Oikeh, Kwabena Obeng Sarpong, Danielle Takacs, Sarah R. Risen
Children with abusive head trauma (AHT) are at high risk for clinical and electrographic seizures, yet postdischarge epileptic outcomes remain incompletely characterized. We performed a single-center retrospective cohort study of 97 children with expert-confirmed AHT admitted between 2018 and 2023. Forty-three patients (44.3%) presented with concern for clinical seizures, and 33 (34.0%) had seizures during hospitalization. Among 62 patients monitored with continuous electroencephalography (EEG), 29 (46.8%) had electrographic seizures; 15 of these 29 (51.7%) were exclusively electrographic, and 26 (89.7%) had documented status epilepticus. Nine of 25 monitored patients without clinical seizures at presentation had electrographic seizures. Among 76 patients with postdischarge follow-up, 12 (15.8%) had seizure recurrence and 2 developed infantile spasms. Inpatient status epilepticus was associated with postdischarge seizure recurrence (odds ratio 10.29, 95% CI 2.20-67.09;