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. 2010 Jul 20;75(3):224-9.
doi: 10.1212/WNL.0b013e3181e8e6d0.

Correlates of posttraumatic epilepsy 35 years following combat brain injury

V Raymont  1 , A M Salazar, R Lipsky, D Goldman, G Tasick, J Grafman
Affiliations

Correlates of posttraumatic epilepsy 35 years following combat brain injury

V Raymont et al. Neurology. .

Abstract

Background: The Vietnam Head Injury Study (VHIS) is a prospective, longitudinal follow-up of 1,221 Vietnam War veterans with mostly penetrating head injuries (PHIs). The high prevalence (45%-53%) of posttraumatic epilepsy (PTE) in this unique cohort makes it valuable for study.

Methods: A standardized multidisciplinary neurologic, cognitive, behavioral, and brain imaging evaluation was conducted on 199 VHIS veterans plus uninjured controls, some 30 to 35 years after injury, as part of phase 3 of this study.

Results: The prevalence of seizures (87 patients, 43.7%) was similar to that found during phase 2 evaluations 20 years earlier, but 11 of 87 (12.6%) reported very late onset of PTE after phase 2 (more than 14 years after injury). Those patients were not different from patients with earlier-onset PTE in any of the measures studied. Within the phase 3 cohort, the most common seizure type last experienced was complex partial seizures (31.0%), with increasing frequency after injury. Of subjects with PTE, 88% were receiving anticonvulsants. Left parietal lobe lesions and retained ferric metal fragments were associated with PTE in a logistic regression model. Total brain volume loss predicted seizure frequency.

Conclusions: Patients with PHI carry a high risk of PTE decades after their injury, and so require long-term medical follow-up. Lesion location, lesion size, and lesion type were predictors of PTE.

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Figure Prevalence of posttraumatic epilepsy in years after traumatic brain injury
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References

    1. Temkin NR, Dikmen SS, Wilensky AJ, Keihm J, Chabal S, Winn HR. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med 1990;323:497–502. - PubMed
    1. Diaz-Arrastia R, Gong Y, Fair S, et al. Increased risk of late posttraumatic seizures associated with inheritance of APOE epsilon4 allele. Arch Neurol 2003;60:818–822. - PubMed
    1. Feeney DM, Walker AE. The prediction of posttraumatic epilepsy: a mathematical approach. Arch Neurol 1979;36:8–12. - PubMed
    1. Annegers JF, Hauser WA, Coan SP, Rocca WA. A population-based study of seizures after traumatic brain injuries. N Engl J Med 1998;338:20–24. - PubMed
    1. Salazar AM, Aarabi B, Levi L, Feinsod M. Posttraumatic epilepsy following craniocerebral missile wounds in recent armed conflicts. In: Aarabi B, Kaufman HH, eds. Missile Wounds of the Head and Neck. Park Ridge, IL: American Association of Neurological Surgeons Neurosurgical Topics Series; 1999:281–292.

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