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Chapter 17. Antiseizure prophylaxis

Posttraumatic seizures are defined as occurring early, within 7 days of injury, or late, beyond 8 days of recovery (1). Risk factors associated with the occurrence of PTS include location of the lesion, cerebral contusions, retained bone and metal fragments, depressed skull fracture, focal neurologic deficits, loss of consciousness, Glasgow Coma Scale (GCS) score 10, severity of injury, length of posttraumatic amnesia, subdural or epidural hematoma, penetrating injury, chronic alcoholism, and age. Infants and children have lower seizure thresholds (2), adding to the challenge of recognition of subtle clinical seizures (3) in critically ill children.