Post-traumatic seizures and factors associated among adult patients with depressed skull fractures at Mulago National Referral hospital; cross-sectional study

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Ronald Oboth

Makerere University Kampala, Uganda

: Int J Ment Health Psychiatry

Abstract

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Introduction: Post-traumatic seizures (PTS) are common among patients with depressed skull fractures (DSF). Understanding the burden of post traumatic seizures and the factors associated among adult patients with DSF is important to improve clinical care. Objective: To determine the prevalence and factors associated with post-traumatic seizures among adult patients with DSF at Mulago National Referral hospital (MNRH). Methods: A cross-sectional study was conducted among 333 study participants between March 2021 and February 2022. Socio-demographic, clinical laboratory factors and anti-seizure medications were collected using a study questionnaire. Data was analyzed to determine the prevalence of PTS and factors associated with occurrence of PTS among patients with DSF. Results: The mean age (±SD) of study participants was 31.2, (±10.5) years, with a male to female ratio of 10.4:1. Nearly half of the study participants had attained secondary level of education, while 31.6 % (1 0 5) were peasants (subsistence farmers). The overall prevalence of PTS among DSF study participants was 16.2 % (54participants). Late presentation of PTS was the highest at 9.0 % (30) followed by early PTS at 3.9 % (13) and immediate PTS at 3.3 % (11). Moderate Glasgow coma score (GCS: 9-13), p < 0.015, severe traumatic brain injury (GCS: 3-8), p < 0.026 at the time of admission and midline brain shift (≥5mm), p < 0.009 were associated with PTS. Phenytoin (94.3 %) was the most commonly used ASM followed by phenobarbitone (1.4 %) and Valproate (1.1 %) among study participants. Conclusion: Patients with moderate and severe traumatic brain injury and midline brain shift were associated with post-traumatic seizures. Early identification and intervention may reduce the burden of posttraumatic seizures in this category of patients.

Biography

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Ronald Oboth is a general neurosurgeon from a low-income country, Uganda, the pearl of Africa. A member of the Neurosurgical Society of Uganda (NSU). Awardee of Makerere College of Health Sciences -Brain Health Training Program scholarship (National Institute of Neurological Disorders and Stroke and the National Institute of Health under Award Number D43NS118560). Aspiring Ph.D. fellow with a research concept derived from the same subject of post-traumatic seizures management in moderate to severe traumatic brain injury.