Research Reports - Risk of epilepsy after traumatic brain injury

J Neurol Neurosurg Psychiatry. 2012 Oct 31

Yeh CC, Chen TL, Hu CJ, Chiu WT, Liao CC

OBJECTIVE: To investigate the associated risk of epilepsy after traumatic brain
injury (TBI) in a population-based retrospective cohort study. METHODS: Using
Taiwan's National Health Insurance Research Database of reimbursement claims, we
conducted a retrospective cohort study of 19 336 TBI patients and 540 322 non-TBI
participants aged ≥15 years as reference group. Data on newly developed epilepsy
after TBI with 5-8 years' follow-up during 2000 to 2008 were collected. HRs and
95% CIs for the risk of epilepsy associated with TBI were analysed with
multivariate Cox proportional hazards regressions. RESULTS: Compared with the
non-TBI cohort, the adjusted HRs of developing epilepsy among TBI patients with
skull fracture, severe or mild brain injury were 10.6 (95% CI 7.14 to 15.8), 5.05
(95% CI 4.40 to 5.79) and 3.02 (95% CI 2.42 to 3.77), respectively. During
follow-up, men exhibited higher risks of post-TBI epilepsy. Patients who had
mixed types of cerebral haemorrhage were at the highest risk of epilepsy compared
with the non-TBI cohort (HR 7.83, 95% CI 4.69 to 13.0). The risk of post-TBI
epilepsy was highest within the first year after TBI (HR 38.2, 95% CI 21.7 to
67.0). CONCLUSIONS: The risk of epilepsy after TBI varied by patient gender, age,
latent interval and complexity of TBI. Integrated care for early identification
and treatment of post-trauma epilepsy were crucial for TBI patients.

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