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Risk of epilepsy after traumatic brain injury: a retrospective population-based cohort study

Chun-Chieh Yeh, Ta-Liang Chen, Chaur-Jong Hu, Wen-Ta Chiu, Chien-Chang Liao

J Neurol Neurosurg Psychiatry 2013;84:441-445 doi:10.1136/jnnp-2012-302547

Neurosurgery

 

Abstract

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.

 

Correspondence to

Assistant Professor Chien-Chang Liao, Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing Street, Taipei 110, Taiwan; This e-mail address is being protected from spambots. You need JavaScript enabled to view it

 

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