【Abstract】 Objective To explore the influencing factors of early epileptic seizures in patients with severe head injury in plateau area. MethodsThe clinical data of 500 patients with severe head injury who were diagnosed and treated in Ganzi Tibetan Autonomous Prefecture People′s Hospital， from March 2016 to March 2021 were retrospectively analyzed. According to whether the patients had early seizures，they were divided into observation group (patients with early seizures，n=50)，control group (patients did not have early seizures，n=450). Single factor and multivariate Logistic regression were used to analyze the influencing factors of early epileptic seizures in patients with severe head injury at high altitude. Results The results of univariate analysis showed that the results of univariate analysis showed the occurrence of early epilepsy in patients with severe head injury of different ages，different genders，different skull fractures，different electrolytes，different history of hypertension，different diabetes history，and different family history of epilepsy The difference was not statistically significant (P>0.05). Midline shift，complicated hydrocephalus，intracranial hematoma，complicated brain contusion and laceration，and rupture of the dura may be related factors affecting early epileptic seizures in patients with severe head injury (P<0.05). The index of the univariate analysis was incorporated into the multivariate logistic regression model，and the multiple linear regression analysis was performed. The results showed that brain contusion and laceration and midline displacement are independent risk factors that affect early-onset seizures in patients with severe head injury (P<0.05). ConclusionCerebral contusion and laceration and midline displacement are independent risk factors that affect early epileptic seizures in patients with severe head injury at high altitude，and should be closely monitored in clinical practice.