Incidence and risk factors of posttraumatic seizures following traumatic brain injury: A traumatic brain injury model systems study

Model System:

TBI

Reference Type:

Journal

Accession No.:

J74973

Journal:

Epilepsia

Year, Volume, Issue, Page(s):

2016 , , ,

Publication Website:

Abstract:

Study determined incidence of posttraumatic seizure (PTS) following traumatic brain injury (TBI) among individuals with moderate-to-severe TBI requiring rehabilitation and surviving at least 5 years. Data obtained from the TBI Model Systems National Database were used to calculate PTS incidence during acute hospitalization, and at 1, 2, and 5 years postinjury in a continuously followed cohort of 795 participants enrolled from 1989 to 2000. Incidence rates were stratified by risk factors, and adjusted relative risk (RR) was calculated. Late PTS associations with immediate (less than 24 hours), early (24 hours to 7 days), or late seizures (more than 7 days) versus no seizure prior to discharge from acute hospitalization was also examined. PTS incidence during acute hospitalization was highest immediately post-TBI (8.9 percent). New onset PTS incidence was greatest between discharge from inpatient rehabilitation and year 1 (9.2 percent). Late PTS cumulative incidence from injury to year 1 was 11.9 percent, and reached 20.5 percent by year 5. Immediate/early PTS RR (2.04) was increased for those undergoing surgical evacuation procedures. Late PTS RR was significantly greater for individuals who self-identified as a race other than black/white (year 1 RR = 2.22), and for black individuals (year 5 RR = 3.02) versus white individuals. Late PTS was greater for individuals with subarachnoid hemorrhage (year 1 RR = 2.06) and individuals age 23–32 (year 5 RR = 2.43) and 33–44 (year 5 RR = 3.02). Late PTS RR years 1 and 5 was significantly higher for those undergoing surgical evacuation procedures. Findings suggest that individuals with immediate/late seizures during acute hospitalization have increased late PTS risk. Race, intracranial pathologies, and neurosurgical procedures also influenced PTS RR.

Author(s):

Ritter, Anne C., Wagner, Amy K., Fabio, Anthony, Pugh, Mary Jo, Walker, William C., Szaflarski, Jerzy P., Zafonte, Ross D., Brown, Allen W., Hammond, Flora M., Bushnik, Tamara, Johnson-Green, Doug, Shea, Timothy, Krellman, Jason W., Rosenthal, Joseph A., Dreer, Laura E.