The management of immediate post-traumatic seizures in children following minor head injury - time for a multicentre study?

Background: Children have a much lower threshold for seizure activity than adults. Consequently, an immediate post-traumatic seizure in a child following a minor head injury does not have the same potentially serious implications as one in an adult. Methods: The records of children admitted with a post-traumatic fit occurring within 24 h of a minor head injury and with a normal CT scan of the brain on admission were critically reviewed. Those with previous neurological disorders, especially fits (excepting febrile convulsions), or systemic injuries requiring admission to an intensive care unit were excluded. Results: There were 13 children who were not intubated and ventilated, forming the control group, and 13 children who were intubated and ventilated and formed the study group. All the children in both these groups made a good recovery, and none of them had any neurological deficit either at discharge or at follow-up. Conclusion: The clinical data suggest that children with immediate post-traumatic seizures following a minor head injury whose CT scan shows no major intracranial abnormalities and who have no prior history of neurological disease are at low risk of developing recurrent seizures or neurological complications and can be safely managed without recourse to intubation and ventilation.