ORIGINAL RESEARCH article
Front. Neurol.
Sec. Pediatric Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1629669
A Retrospective Cohort Study on the Seizure risks and Outcomes of Children with Acquired Brain Injury (ABI)
Provisionally accepted
- 1Queen Mary Hospital, Hong Kong, Hong Kong, SAR China
- 2The University of Hong Kong, Pokfulam, Hong Kong, SAR China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract Background The purpose of this study is to determine the prevalence, risk factors, and characteristics of seizures and epilepsy in children with acquired brain injury (ABI), and compare their outcomes with children with ABI but no seizures. Method Basic demographic data, clinical features, brain injury severity, seizure and epilepsy characteristics, and functional and neurodevelopmental outcomes of children with ABI with follow-up of at least 2 years were reviewed. Logistic regression was performed to determine the risk factors for seizures. Results The study included 82 children with ABI due to tumours, trauma, hypoxia, stroke, infection, and neuro-inflammatory disorders. There were 43 (52%) boys. The median age at diagnosis was 2.9 years and median follow-up interval was 5 years. A total of 27 (33%) children experienced seizures and 20 (24%) were diagnosed as having epilepsy. Risk factors for seizures included cortical brain injury (p = 0.013) and CNS infection (p = 0.001). Among those with seizures, 7 had acute seizures within 7 days of ABI. The median time of onset of epilepsy after ABI was 2 years, and 5 children had refractory epilepsy needing more than two anti-epileptics. The Hazard Ratio (HR) for epilepsy in those with cortical brain injuries and CNS infections were 4.582 (95% CI [1.83, 11.49], p = 0.001) and 4.796 (95% CI [1.568, 14.67], p = 0.006) respectively. HR for epilepsy onset in those who had post-stroke seizures were 4.467, 95% CI [1.575, 12.67], p =0.005). Most subjects demonstrated significant improvements in Karnofsky Performance Scale scores following rehabilitation (p < 0.0001); however, a greater proportion of children with post-ABI seizures required special educational services (p = 0.025) Interpretation Cortical brain injuries, CNS infection and post-stroke seizures significantly increase the risk of epilepsy in children with ABI. While functional improvements were observed after rehabilitation, children with post-ABI seizures more often required special educational support. The identification of risk factors for seizures, time to epilepsy onset, and the functional outcomes can guide subsequent management and counselling.
Keywords: paediatric acquired brain injuries, Seizures, Epilepsy, functional outcome, Rehablitation
Received: 16 May 2025; Accepted: 17 Aug 2025.
Copyright: © 2025 Li, Wang and Tso. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Winnie Wan Yee Tso, The University of Hong Kong, Pokfulam, Hong Kong, SAR China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.