Rationale: Patients with traumatic brain injury (TBI) are at risk for seizures and other potentially epileptogenic patterns. These can have permanent adverse effects on the brain. We aimed to report the incidence of seizures and continuous EEG (cEEG) abnormalities after TBI and identify any risk factors associated with the development of these abnormalities. Methods: This retrospective study identified 244 adult patients with a mild to severe TBI who had a cEEG performed within one week of admission to Spectrum Health Butterworth Hospital between July 2014 and July 2019. Data was manually and electronically extracted from the medical record. Results: We found that 12% of patients with TBI developed seizures and an additional 23% developed potentially epileptogenic patterns. Age, African American race, history of epilepsy or prior TBI, hypertension, bleeding disorder, dementia, and prior cerebrovascular accident were associated with an increased risk of developing seizures or potentially epileptogenic patterns. The presence of a skull fracture, type of intracranial hemorrhage, and location of intracranial hemorrhage were not associated with an increased risk. Conclusions: Thirty-five percent of patients who presented with TBI developed seizures or potentially epileptogenic patterns. The incidence of EEG abnormalities in this study is higher than previously reported and these patients are at risk for permanent neurological changes. We recommend the routine use of cEEG for all critically ill patients with TBI, and we recommend considering the use of cEEG for patients who are not critically ill but may be at higher risk of developing seizure or potentially epileptogenic patterns due to age, race, or comorbidities. Funding: Please list any funding that was received in support of this abstract.: Spectrum Health Trauma Research Institute
