Research Reports - Risk of epilepsy after traumatic brain injury

J Neurol Neurosurg Psychiatry. 2013 Apr;84(4):441-5

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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