Incidence and Risk Factors of Early Post-traumatic Seizures in Nigerians

Objectives: To determine the incidence and risk factors of early post-traumatic seizures (PTS) in Nigerian subjects. Methods: Subjects were recruited consecutively, classified as mild, moderate or severe traumatic brain injury (TBI), and followed for 168 hrs for development of seizures. Results: There were 266 subjects, 213 (80%) males and 53 (20%) females, with mean age 31 years (sd 18, range 1-80, median 30). Causes of TBI were motor traffic accident (MTA) related in 217 (82%), falls in 25 (9%), struck by objects in 15 (5%), firearms in 4 (2%), sports and recreation in 3 (1%), and failed suicide in 2 (1%). Cumulative incidence of early PTS was 119% (95% CI 80-156). Risk factors were age <= 12 years, severity of TBI, history of seizures, and TBI at weekend, but gender and GCS were not. Skeletomotor palsy was independently associated with early PTS. Conclusions: Incidence of early PTS is high in this population, probably due to the relatively high proportion of severe TBI. Risk factors are TBI severity, young age, history of seizures, and TBI at weekends. The best preventive strategy is reduction of MTA, which causes over 80% of TBI. Prophylactic anti-seizure therapy may benefit subjects with severe TBI and skeletomotor deficits.