Primary objective: To better characterize, describe and highlight issues that individuals with TBI and active LPTS may face in their daily lives.Design: Prospective multi-centre mixed method qualitative and quantitative interview.Participants: Twenty-five individuals, 5–13 years post-injury, who had reported having LPTS and TBI.Measures: Disability Rating Scale (DRS); Supervision Rating Scale (SRS); Glasgow Outcome Scale–Extended (GOS-E); Perceived Stress Scale (PSS); Craig Handicap Assessment Reporting Technique-Short Form (CHART-SF) sub-scales: Physical Independence, Cognitive Independence, Mobility, Occupation, Social Integration; and Craig Hospital Inventory of Environmental Factors (CHIEF); and qualitative interview questions pertaining to management of the seizure disorder and its effect on the individual's health, function, community integration and participation.Results: Data are presented regarding seizure activity and management; return to driving post-seizure; coping and participation; and stan...

Impact of late post-traumatic seizures on physical health and functioning for individuals with brain injury within the community.

Effect of lacosamide on structural damage and functional recovery after traumatic brain injury in rats

Supratentorial atypical teratoid rhabdoid tumor (ATRT) in many cases has a distinctive appearance on post-gadolinium MRI. We sought to determine whether this is a unique appearance allowing ATRT to be distinguished accurately from other types of pediatric supratentorial tumors. Retrospective review of all available preoperative MRI of pediatric supratentorial tumors at two tertiary children’s hospitals, and systematic literature review of case series and reports describing the MRI imaging appearances of supratentorial ATRT. We had 61 supratentorial tumors, including 32 gliomas, 6 ATRT, 8 ependymomas, 6 gangliogliomas, 2 pilomyxoid astrocytomas, 3 primitive neuro-ectodermal tumors, 2 choroid plexus papillomas, and 2 meningiomas. ATRT presented in significantly younger patients than astrocytomas (mean age 2.6 years vs. 9.9 years, P < 0.05). The visual pattern of a thick, wavy (irregular) heterogeneously enhancing wall around a cystic center was seen in 5/6 (83%) ATRTs and only 3/55 (5.4%) other tumors (P < 0.0001), for specificity of 95%, sensitivity of 83%, positive predictive value of 63% and a negative predictive value of 95%. A supratentorial tumor with a thick, wavy (irregular) heterogeneously enhancing wall surrounding a central cystic region is suggestive of ATRT in the appropriate clinical setting, especially in a child of preschool age.

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How specific is the MRI appearance of supratentorial atypical teratoid rhabdoid tumors

Background: The incidence of early post-traumatic seizures after civilian traumatic brain injury ranges 4–25%. The control of early post-traumatic seizure is mandatory because these acute insults may add secondary damage to the already damaged brain with poor outcome. Prophylactic use of anti-epileptic drugs have been found to be have variable efficacy against early post-traumatic seizures. The objective of this study was to compare the efficacy of Phenytion and Levetiracetam in prevention of early post-traumatic seizures in moderate to severe traumatic brain injury. Methods : This Randomized Controlled Trial was conducted in department of Neurosurgery, Ayub Medical College, Abbottabad from March, 2012 to March 2014. The patients with moderate to severe head injury were randomly allocated in two groups. Patients in group A were given phenytoin and patients in group B were given Levetiracetam. Patients were followed for one week to detect efficacy of drug in terms of early post traumatic seizures. Results: The 154 patients included in the study were equally divided into two groups. Out of 154 patients 115 (74.7%) were male while 29 (25.3%) were females. Age of patients ranges from 7–48 (24.15±9.56) years. Ninety one (59.1%) patients had moderate head injury while 63 (40.9%) patients had severe head injury. Phenytoin was effective in preventing early post traumatic seizures in 73 (94.8%) patients whereas Levetiracetam effectively controlled seizures in 70 (90.95%) cases ( p -value of .348). Conclusion: There is no statistically significant difference in the efficacy of Phenytoin and Levetiracetam in prophylaxis of early post-traumatic seizures in cases of moderate to severe traumatic brain injury. Keywords: Phenytoin; Levetiracetam; Seizures; Post-traumatic; Epilepsy; Trauma; Head injury

Comparison Of Efficacy Of Phenytoin And Levetiracetam For Prevention Of Early Post Traumatic Seizures.

Advance technology and life science significantly prolongs human’s lifespan. The prolonged longevity enables people to enjoy longer life but adversely increases the mortality and morbidity of aging-related disorders which may, in turn, devalue the quality of late life. Of the aging-related neurological conditions, increased incidence and prevalence of convulsive disorders, namely seizures or epilepsies, have been documented in literature. Epilepsy is the third most common neurological condition after dementia and stroke among the elderly. Multiple risk factors cause the elderly to be prone to develop seizures or epilepsies, including advanced aging, stroke, traumatic brain injury, dementia, neurodegenerative diseases, brain tumors, obstructive sleep apnea, and obesity. In this article, we highlight the epidemiology, pathophysiology, and clinical manifestations of elderly seizures.

Epilepsy in Elderly

Background: Post-traumatic seizure is a well-known and serious
complication of traumatic brain injury (TBI). The incidence and risk
factors vary among study populations. Very little data have been
published concerning this in the Malaysian population. The aim of this
study was to ascertain the risk factors for the development of early
post-traumatic seizures among patients with TBI. Methods: This was a
prospective observational study, carried out in Hospital Universiti
Sains Malaysia, Kubang Kerian, Kelantan, under the Department of
Neurosciences. A total of 157 patients, from all age groups, who were
diagnosed with TBI were enrolled from June 2007 to December 2007. They
were followed-up for 12 months until death or their first
post-traumatic seizure. Survival analysis with Kaplan–Meier
curves and Cox proportional hazards regression was performed. Results:
A total of 11 (7.0%) of the patients developed early post-traumatic
seizures. The risk factors for early post-traumatic seizures were young
age (P = 0.021, 95% CI 0.806 to 0.982) and intubated patients (P =
0.029, 95% CI 1.194 to 25.913). The incidence of early post-traumatic
seizures in the local population was 7.0%. Conclusion: The incidence of
early post-traumatic seizures in the local population of Kelantan and
Terengganu is comparable to the incidences reported elsewhere. Younger
as well as intubated patients were at a higher risk of developing this
condition. It may be necessary to give antiepileptic prophylaxis
because any seizure could adversely affect morbidity and mortality.
However, the study showed that antiepileptic drug was not beneficial in
preventing late post-traumatic seizures, but may have a role in
preventing early seizures.

Risk Factors and Phenytoin Prophylaxis for Early Post-Traumatic Seizures among Patients with Traumatic Brain Injury.

Primary central nervous system atypical rhabdoid/teratoid tumour (ATRT) is a rare and highly malignant tumour that tends to occur in infancy and early childhood. The majority of tumours (approximately two-third) arise in the posterior fossa. The optimal treatment for ATRT remains unclear. Options of treatment include surgery, radiotherapy, and chemotherapy. Each of their role is still not clearly defined until now. The prognosis of the disease is generally unfavourable. This is a case report of ATRT in an atypical site in a 9-year-old girl.

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Yew Chin Tan

Papers

Risk Factors and Phenytoin Prophylaxis for Early Post-Traumatic Seizures among Patients with Traumatic Brain Injury.

A case report of atypical teratoid/rhabdoid tumour in a 9-year-old girl.